Podcasts about Nassau County

Claire de Mézerville López welcomes IIRP alumnus, Gregg Scheiner, to the Restorative Works! Podcast. Gregg joins us and shares how his inclusive approach to mediation and conflict resolution empowers students and community members alike. He shares impactful stories, such as his work with a Nassau County high school where students and staff engaged in peer mediation sessions, leading to lasting resolutions and strengthened community bonds. He introduces us to the innovative Truancy Continuum of Care project, which utilizes restorative principles to reintegrate students into classrooms with supportive, non-punitive strategies. His initiatives have significantly reduced truancy rates and fostered a sense of belonging among students. Gregg is the director of restorative practices at the Long Island Dispute Resolution Center of the EAC Network (LIDRC). Gregg has been an integral part of this Resolution Center team for over a decade. He previously served as trainer and outreach coordinator, making significant contributions to advancing restorative practices across Long Island. As a circles and restrictive practices trainer, he has developed impactful programs in conflict resolution, peer mediation, and diversity training. His work has strengthened partnerships with schools, nonprofits, and government agencies, expanding LIDRC's reach and impact. Gregg holds a Master of Science in Restorative Practices from the IIRP, Master of Business Administration in Marketing from Adelphi University, as well as a leadership certificate, and a Bachelor of Arts from Hofstra University in Cultural Anthropology with a minor in Sociology.  Tune in to hear more as Gregg discusses the future of restorative practices beyond educational settings, envisioning a society where these principles guide all interactions, fostering social-emotional intelligence and balanced relationships.

Sometime ago I had the pleasure to have as a guest a gentleman named Rob Wentz. Rob appeared in episode 212 on March 8, 2024. Recently Rob introduced me to a man he described as amazing and definitely unstoppable. That introduction led to me having the opportunity to have today, Ken Kunken, the man Rob introduced me to. Ken's story is atypical to most. He had a pretty normal childhood until he went to Cornell. Rob was pretty short, but he loved all things sports and active. In his junior year he participated in a lightweight football game against Columbia University. On a kickoff he tackled an opponent but broke his neck in the process. Immediately he became a quadriplegic from the shoulders down. As he tells us, his days of physical activity and sports came to an abrupt end.   I asked Ken how he dealt with his injury. As he tells me, his family rallied around him and told him they were all there to help with whatever he needed to continue in school and to move on with his life. They were true to their word and Ken did continue to attend school after nine months of hospitalization. He secured a bachelor's degree in industrial engineering. He went on to get a Master's degree from Cornell in Industrial Engineering and then a second Master's degree this time from Columbia University in Psychology as he decided he really wanted to “help people especially those with serious disabilities” rather than continuing in the Civil Engineering arena. Ken then secured a job that led to him becoming a successful rehabilitation counselor in New York.   Ken wasn't done growing nor exploring. After two years working in the rehabilitation field through circumstances and advice from others, he went to Hofstra school of law where he obtained a Juris Doctor degree in 1982. He then went to work in the office of a district attorney where, over 40 years he progressed and grew in stature and rank.   Ken tells us how his life changed over time and through the many jobs and opportunities he decided to take. Twenty-two years ago, he married Anna. They ended up having triplet boys who now all are in school at the age of Twenty.   Ken is as unstoppable as it gets. He refused to back down from challenges. He is now retired and loving the opportunity to be with his family and help others by telling his story.     About the Guest:   In 1970, while a junior in Cornell University's College of Engineering, Ken Kunken broke his neck making a tackle on a kick-off in a lightweight football game against Columbia University. Ken sustained a spinal cord injury at the C 4-5 level, rendering him a quadriplegic, almost totally paralyzed from the shoulders down. Ken spent more than 9 months in various hospitals and rehabilitation facilities. While still a patient, Ken testified before a United States Senate Sub-Committee on Health Care, chaired by Senator Edward Kennedy. In 1971, almost 20 years before the Americans with Disabilities Act, Ken returned to the Cornell campus, where he completed his undergraduate degree in Industrial Engineering. Ken estimates that he had to be pulled up or bounced down close to 100 steps just to attend his first day of classes.   Ken is the first quadriplegic to graduate from Cornell University. Upon graduation, Ken decided to change his career goal. He wanted to work with and help people, particularly those with disabilities. Ken went on to earn a Master of Arts degree at Cornell in education and a Master of Education degree at Columbia University in psychology. Ken is the first quadriplegic to earn a graduate degree from Cornell University. In 1977, Ken was hired by Abilities Inc. in Albertson, NY to be its College Work Orientation Program Coordinator. Ken coordinated a program which provided educationally related work experiences for severely disabled college students. He also maintained a vocational counseling caseload of more than 20 severely disabled individuals.   While working at the Center, Ken became a nationally certified rehabilitation counselor and made numerous public presentations on non-discrimination, affirmative action and employment of the disabled. In 1977, Ken was named the Long Island Rehabilitation Associations “Rehabilitant of the Year” and in 1979 Ken was the subject of one of the Reverend Norman Vincent Peale's nationally syndicated radio broadcasts “The American Character”. Wanting to accomplish still more, Ken enrolled in Hofstra University's School of Law, where he earned a Juris Doctor degree in 1982. Ken then went to work as an assistant district attorney in Nassau County, Long Island.   Ken was promoted a number of times during his more than 40 years with the District Attorney's Office, eventually becoming one of the Deputy Bureau Chiefs of the County Court Trial Bureau, where he helped supervise more than 20 other assistant district attorneys. In addition, over his years working in the Office, Ken supervised more than 50 student interns.   In 1996 Ken received the Honorable Thomas E. Ryan, Jr. Award presented by the Court Officers Benevolent Association of Nassau County for outstanding and dedicated service as an Assistant District Attorney. In 1999, Ken was awarded the George M. Estabrook Distinguished Service Award presented by the Hofstra Alumni Association, Inc. Beginning in 2005, for nine consecutive years, “The Ken Kunken Most Valuable Player Award” was presented annually by The Adirondack Trust Allegiance Bowl in Saratoga Springs, NY, in recognition of Ken's personal accomplishments, contributions to society and extraordinary courage.   In 2009, Ken became a member of the Board of Directors of Abilities Inc., and in 2017 he became a member of the Board of Directors for the parent company of Abilities Inc., the Viscardi Center.   In 2020, Ken was inducted into “The Susan M. Daniels Disability Mentoring Hall of Fame,” as a member of the class of 2019.   In December 2023, “The Kenneth J. Kunken Award” was presented by the Nassau County District Attorney's Office, for the first time, to an outstanding Nassau County Assistant District Attorney who personifies Ken's unique spirit and love of trial work, as well as his commitment and dedication, loyalty to his colleagues and his devotion to doing justice. The Award will be presented annually.   In March 2024, Ken was named one of the Long Island Business News Influencers in Law. Ken retired from full-time employment in 2016, but continued to work with the District Attorney's Office for the next eight years in a part time capacity, providing continuing legal education lectures and litigation guidance.   For years, Ken has tried to inspire people to do more with their lives. In October 2023, Ken's memoir “I Dream of Things That Never Were: The Ken Kunken Story” was published. In 2003 Ken married Anna and in 2005 they became the proud parents of triplet boys: Joey, Jimmy and Timmy. On June 23, 2023 the triplets graduated from Oceanside High School, fifty-five years after Ken had graduated from the same school. Ways to connect with Ken:   https://www.facebook.com/ken.kunken https://www.facebook.com/profile.php?id=61566473121422 https://www.instagram.com/ken.kunken/ https://www.linkedin.com/in/kenneth-j-kunken-b4b0a9a8/ https://www.youtube.com/@Ken.Kunken https://bsky.app/profile/kenkunken.bsky.social   About the Host:   Michael Hingson is a New York Times best-selling author, international lecturer, and Chief Vision Officer for accessiBe. Michael, blind since birth, survived the 9/11 attacks with the help of his guide dog Roselle. This story is the subject of his best-selling book, Thunder Dog.   Michael gives over 100 presentations around the world each year speaking to influential groups such as Exxon Mobile, AT&T, Federal Express, Scripps College, Rutgers University, Children's Hospital, and the American Red Cross just to name a few. He is Ambassador for the National Braille Literacy Campaign for the National Federation of the Blind and also serves as Ambassador for the American Humane Association's 2012 Hero Dog Awards.   https://michaelhingson.com https://www.facebook.com/michael.hingson.author.speaker/ https://twitter.com/mhingson https://www.youtube.com/user/mhingson https://www.linkedin.com/in/michaelhingson/   accessiBe Links https://accessibe.com/ https://www.youtube.com/c/accessiBe https://www.linkedin.com/company/accessibe/mycompany/ https://www.facebook.com/accessibe/       Thanks for listening!   Thanks so much for listening to our podcast! If you enjoyed this episode and think that others could benefit from listening, please share it using the social media buttons on this page. Do you have some feedback or questions about this episode? Leave a comment in the section below!   Subscribe to the podcast   If you would like to get automatic updates of new podcast episodes, you can subscribe to the podcast on Apple Podcasts or Stitcher. You can subscribe in your favorite podcast app. You can also support our podcast through our tip jar https://tips.pinecast.com/jar/unstoppable-mindset .   Leave us an Apple Podcasts review   Ratings and reviews from our listeners are extremely valuable to us and greatly appreciated. They help our podcast rank higher on Apple Podcasts, which exposes our show to more awesome listeners like you. If you have a minute, please leave an honest review on Apple Podcasts.       Transcription Notes:   Michael Hingson ** 00:00 Access Cast and accessiBe Initiative presents Unstoppable Mindset. The podcast where inclusion, diversity and the unexpected meet. Hi, I'm Michael Hingson, Chief Vision Officer for accessiBe and the author of the number one New York Times bestselling book, Thunder dog, the story of a blind man, his guide dog and the triumph of trust. Thanks for joining me on my podcast as we explore our own blinding fears of inclusion unacceptance and our resistance to change. We will discover the idea that no matter the situation, or the people we encounter, our own fears, and prejudices often are our strongest barriers to moving forward. The unstoppable mindset podcast is sponsored by accessiBe, that's a c c e s s i capital B e. Visit www.accessibe.com to learn how you can make your website accessible for persons with disabilities. And to help make the internet fully inclusive by the year 2025. Glad you dropped by we're happy to meet you and to have you here with us.   Michael Hingson ** 01:20 Well, hello once again, and welcome to another episode of unstoppable mindset. I am your host, Michael hingson, and today we have a fascinating guest, I believe. Anyway, his name is Ken. Kuan, kunken. Am I pronouncing that right? Yes, you are. Oh, good. And Ken, in 1970 underwent a problem when he was playing football and doing a tackle on a kickoff. Namely, he broke his neck and became a quadriplegic, basically from the shoulders down. I'm sort of familiar with the concept, because my wife, from birth was in a wheelchair. She was a paraplegic, paralyzed from the t3 vertebrae down, which was like right below the breast, so she was able to transfer and so on. So not quite the same, but a lot of the same issues, of course, and we're going to talk about that basically, because when you're in a wheelchair, like a lot of other kinds of disabilities, society doesn't tend to do all they should to accommodate. And I can, can make that case very well. Most people are light dependent, and we have provided reasonable accommodations for them by providing light bulbs and light on demand wherever they go, wherever they are, whatever they do, while at the same time for people who are blind, we don't get the same degree of access without pushing a lot harder. And people in wheelchairs, of course, have all sorts of physical issues as well, such as stairs and no ramps and other things like that. And I know that Ken's going to talk some about that from university days and my wife Karen face some of the same things. But anyway, we'll get to it all. Ken, I want to welcome you to unstoppable mindset. And I think your wife, Anna is visiting with us also, right, right? Thank you. Michael, so Anna, welcome as well. Thank you so Ken. Why don't we start if we could by you telling us sort of about the early Ken, growing up and all that from being a child, and tell us a little bit about you.   Ken Kunken ** 03:40 Okay, well, if you're going back to my childhood area, Yeah, it sure is. It's quite a while ago, but I was born in 1950 and that happened to be in the midst of the polio epidemic, and unfortunately, my mother contracted polio and died when I was less than one month old. So I have an older brother, Steve, who's two years older than me, and my father brother and I ended up moving in with my grandparents for a few years before my father remarried when I was four years old. A long shot. But what's your birth date? Right? My birth date is July 15, 1950 on   Michael Hingson ** 04:23 February 24 1950 So, okay, was was just kind of hoping there was the possibility, right? Anyway, go ahead.   Ken Kunken ** 04:30 So, um, during my father's second marriage, that's when my sister Merrill was born. She's 10 years younger than I am, but unfortunately, that was not a happy marriage, and it ended in a divorce. And when I was 18, my father married for the third time. So you know, growing up in a household with a number of individuals seemingly coming and going was a little different than most people's   Michael Hingson ** 04:57 households when they were growing up. How. Was that for you?   Ken Kunken ** 05:01 Well, you know, it was nice in the sense that I got involved with a lot of different family members in my extended family. I'm very close, growing up with my grandparents, with aunts, uncles, cousins, as well as my sister and brother. And you know, I had the opportunity to interact with a lot of different people. It was difficult during my father's second marriage, because it was not a happy marriage, and, you know, it worked out in everybody's best interest when that ended in divorce. But I look back at my childhood, and I just basically call it as a very happy childhood?   Michael Hingson ** 05:42 Oh, good. Well, so no real major traumas, certainly differences, but no real harrowing kinds of things that just threw you into a complete topsy turvy at least as far as you're concerned, right? Yeah. Well, then you decided to go to Cornell, as I recall, and I know Cornell has a, I think it's a master's program, but an advanced program in hospitality. So did they feed you well at Cornell?   Ken Kunken ** 06:13 Yes, they had a very good system and fed us very well. And they have a program in hotel management, right, which I was not involved in, but there was a lot of good food at Cornell when we were there.   Michael Hingson ** 06:28 Well, that's that's always important, you know, you got to have good food at UC Irvine. We were okay. Food wise. I was on the food committee for the dorms, actually, and the food was all right, but when they had steak night that they always made a big deal about the steak was usually pretty tough, and so we we had sometimes that the food wasn't great, but they had a great soft serve ice cream machine, so lot of people took advantage of that. But anyway, so when you were at Cornell, you played football,   Ken Kunken ** 07:01 right? I was on their lightweight football team. It's for people that were smaller than the heavyweight team. When I was playing, you had to weigh 154 pounds or less two days before the game. So most of the people had played on their high school teams was too small to play on the varsity college team, but it was a varsity sport. Most of the people were very good athletes and very fast, and it was very competitive sport.   Michael Hingson ** 07:35 So tell us about that and what happened.   Ken Kunken ** 07:38 Well, during my junior year, I was injured making a tackle on a kickoff in a game against Columbia University, and when I tackled the ball carrier, I broke my neck and damaged my spinal cord, and as a result, I'm a quadriplegic. I'm almost totally paralyzed from the shoulders down,   Michael Hingson ** 08:01 and so, what kind of effect? Well, that clearly that that was pretty bad news and so on. So what kind of effect did that have on you, and how did that shape what you did going forward?   Ken Kunken ** 08:15 Oh, it totally changed my perspective on everything about myself. I mean, growing up, my life seemed to center around sports. In high school, I played on the varsity football team. I wrestled on the varsity wrestling team. I played on four different intramural softball teams. I worked on the summer as a lifeguard. Everything in my life revolved around athletics and being physically active. Now, suddenly, I couldn't be physically active at all. In fact, I am totally sedentary, sitting in a wheelchair, and I need assistance with all my activities of daily living now.   Michael Hingson ** 08:54 So what did you do when the injury happened and so on? So how did you deal with all of that?   Ken Kunken ** 09:01 Well, it was a really difficult adjustment to make. I mean, suddenly I became dependent on everybody around me, because there was not one thing I could do for myself. So it was very difficult knowing that now not only was I dependent on others, but I had to be more outgoing to be able to have asked for help when I needed it, which was difficult for me, because I had always considered myself a bit of shy person, a bit of an introvert, and now I needed to be more vocal with respect to all of my needs. So I swear, go ahead. Well, I spent the next nine months and 20 days in various hospitals and rehabilitation centers, and it was really, really difficult getting used to my new physical condition.   Michael Hingson ** 09:52 But at the same time, you could have taken the position that you just hated yourself and you just wanted to I. Make life end and so on. And it doesn't sound like that was the approach that you took.   Ken Kunken ** 10:04 Mike, I was so fortunate that I had a very supportive family who were with me and helped me every step of the way. In fact, they basically assured me that they would act as my arms and legs to make sure I could still do everything I wanted to do in my life   Michael Hingson ** 10:22 doesn't get much better than that, having a real supportive village, if you will.   Ken Kunken ** 10:27 Right? I was so fortunate, and you know, I think that helped me be able to do many things in my life that most people thought would not be possible for someone in my condition, and I was able to do it because of the help I received from my family.   Michael Hingson ** 10:44 So what did you major in at Cornell? Let's say, before the injury.   Ken Kunken ** 10:50 I before my injury, I was majoring in industrial engineering, okay? And you know, after my injury, I went back to school and continued my studies in industrial engineering and actually obtained my degree, a Bachelor of Science in industrial engineering.   Michael Hingson ** 11:08 Now, what primarily is industrial engineering?   Ken Kunken ** 11:12 Well, you know, it's kind of a technical aspect of dealing with men, material, machines, and, you know, most likely working at a business where there are a lot of different people working there, where you would try and find out what the best way of people to operate, whether it be in a factory or just in a large business setting, when you're dealing with technical aspects of the job. But I never actually worked as an engineer, because, following my degree, based on the recommendation of one of my psychology professors, I stayed at Cornell and pursued a career in counseling. And I find that a lot more suitable to not only my physical condition, but what I really wanted to do. Because, following my injury, I knew that what I really wanted to do was to devote my life and career to helping others.   Michael Hingson ** 12:08 So you very well could have made the same switch and made the same choices, even if you hadn't undergone the accident,   Ken Kunken ** 12:17 absolutely and hopefully, I would have, because I found it a lot more enjoyable, and I believe it taught me a lot about dealing with people, and it made me feel very good about myself to know that I was still in a position, despite my disability, where I could help others.   Michael Hingson ** 12:40 So you stayed at Cornell and got that master's degree in counseling, which, which really gave you that opportunity. What did you do after that?   Ken Kunken ** 12:50 Well, to increase my counseling credentials, I then went to Columbia University, where I obtained my second degree. This one was also in counseling. That degree was in psychological counseling and rehabilitation, and I decided to look for a job in the rehabilitation counseling field. And now that I had two degrees from Cornell and one from Columbia, three prestigious Ivy League degrees, two master's degrees, I didn't think I'd have much difficulty securing employment, but to my dismay, no one would hire me. This was in the mid 70s, and everyone seemed to feel I was just too disabled to work.   Michael Hingson ** 13:32 Now, why did you go to Columbia to get your second degree, your masters in rehabilitation,   Ken Kunken ** 13:39 you know? And incidentally, it that was the school I actually was injured against during the football   Michael Hingson ** 13:44 I know that's why I asked the enemy, right?   Ken Kunken ** 13:47 Yeah, but I actually applied there for my doctorate, doctorate in counseling psychology. And initially I didn't get into that program, but they invited me to participate in their master's program, and said that they would reconsider my application when I finished that degree. Now, I thought that was a special letter that I got from them because of my injury, and I thought they just wanted to see me that I could do graduate work. As it turned out, virtually everybody that applied for that program got a similar letter, and when I first met with my advisor there at Columbia, he said, you know, if you didn't get in the first time, you're probably not going to get in even when you graduate. So since I had nothing else to do at that point, I enrolled in the master's program, and I completed my second master's degree. And you know, at the time, even my advisor was pessimistic about my work prospects, wow, just because of my ability, because of my disability, and despite. Fact that here they were training people to be rehabilitation counselors and encouraging people to go into that field, they felt that due to my disability, I would still have a very difficult time gaining employment,   Michael Hingson ** 15:14 which is as ironic as it gets,   Ken Kunken ** 15:17 absolutely, absolutely and I was just very fortunate that there was a facility on Long Island called abilities Incorporated, which was part of what was then called the Human Resources Center. Is now called the Viscardi Center, after its founder, Dr Henry Viscardi, Jr, and they hired me to work as a vocational rehabilitation counselor for other individuals who had severe disabilities.   Michael Hingson ** 15:46 I'm a little bit familiar with the buscardi Center, and have found them to be very open minded in the way they operate.   Ken Kunken ** 15:54 They were terrific, absolutely terrific. And I was so fortunate to get involved with them, to be hired, to work for them, and, you know, to be associated with all the fine work they were doing it on behalf of helping other individuals with disabilities.   Michael Hingson ** 16:13 So was it primarily paraplegics and quadriplegics and so on, or did they do blind people and other disabilities as well.   Ken Kunken ** 16:21 They did a lot of different disabilities, but they did not work with people that were visually impaired. For that in New York state, there was a special agency called the commission for the visually handicapped that helped people with visual impairments, but we dealt with all different types of disabilities, whether people were hearing impaired or had not just spinal cord injuries, but other disabilities, either from birth or disabilities that they developed through diseases. And as it turned out, I was probably one of the most severely disabled of the people that I dealt with.   Michael Hingson ** 17:02 Well, but you were also, by any definition, a good role model.   Ken Kunken ** 17:06 Well, I was fortunate that I was able to help a lot of different people, and I felt that when they looked at me and saw that I was able to work despite my disability, I know it encouraged them to do their best to go out and get a job themselves.   Michael Hingson ** 17:24 And of course, it really ultimately comes down to attitude. And for you, having a positive attitude had to really help a great deal.   Ken Kunken ** 17:34 I think it made all the difference in the world. And I was very fortunate that it was my family that instilled that positive attitude in me, and they gave me so much help that after a while, I thought I'd be letting them down if I didn't do everything I could do to make something out of my life.   Michael Hingson ** 17:53 So what did you do? Well, not only   Ken Kunken ** 17:57 did I go back to school and complete my education, but I went to work and, you know, got up early every day, and with the aid of a personal care attendant, I was able to go to work and function as a vocational counselor and help others in trying to achieve their goals.   Michael Hingson ** 18:17 Now, were you going to school while you were doing some of this?   Ken Kunken ** 18:20 No, I finished my second okay, and now was able to work full time.   Michael Hingson ** 18:27 Okay, so you did that, and how long did you work there?   Ken Kunken ** 18:32 Well, I worked there for a little over two years, and you know, my duties and responsibilities kept expanding while I was there, and one of my duties was to speak at conferences before groups and organizations concerning affirmative action and non discrimination for people with disabilities. And often after my talks, I would be asked questions, and while I would do my best to respond appropriately, I was always careful to caution the question is that they should really consult with a lawyer about their concerns. And I guess it didn't take long before I started to think, you know, there's no reason why I couldn't become that lawyer. So after a little over two years, I decided to leave the job, and I went to Hofstra University School of Law.   Michael Hingson ** 19:20 So now what? What year was this?   Ken Kunken ** 19:24 I left the job. I started the job in 77 I left in 79 when I started law school.   Michael Hingson ** 19:32 Okay, so you went to Hofstra,   Ken Kunken ** 19:35 right? And while I was at Hofstra through my brother's suggestion. My brother was working as a public defender at the time, he suggested I do an internship at the district attorney's office. So after my second year of law school, I did an internship there during the summer, and I found a new way. I could help people and serve the community as a whole, and I really enjoyed that work. So when I was in my third year of law school, I applied for a full time position with the district attorney's office, and I was very fortunate that the district attorney was a very progressive, self confident individual who based his hiring decision on my abilities rather than my disability.   Michael Hingson ** 20:27 Wow, that had to be, especially back then, a fairly, as you said, progressive, but an amazing thing to do, because even today, there are so many times that we get challenges and too many things thrown in our way, but you had someone who really thought enough of you and obviously decided that your abilities were such on the job that you could do   Ken Kunken ** 20:51 it. I was very fortunate to have come in contact with the district attorney at the time. His name was Dennis Dillon, and he seemed to know that when I'd go to court, a jury was not going to base its verdict on my inability to walk, but rather on my skill and competence as an attorney. And thanks to the training and guidance I received in the office, I became a very confident and competent, skilled trial attorney   Michael Hingson ** 21:22 well, and it had to be the way you projected yourself that would convince a jury to decide cases in the right way. So again, kudos to you.   Ken Kunken ** 21:33 Thank you. Well, I certainly did my best to do that, and at the time that I applied for this job, I didn't know of any quadriplegics that were trial attorneys. May have been some, but I didn't know of any. Certainly there were none on Long Island, and certainly no assistant district attorneys at the time that I knew of who were quadriplegics.   Michael Hingson ** 21:59 Now, of course, the question that comes to mind is, so was the office accessible?   Ken Kunken ** 22:05 No question. And you know, let me just go further by telling you that my first day in court, I couldn't even fit through the swinging doorways in the courtroom. They were too narrow to let me get through to get to the prosecutor's table, because my electric wheelchair was too wide.   Michael Hingson ** 22:24 What did you do? Or what happened?   Ken Kunken ** 22:27 Well, eventually they had to take off the swinging doorways and the screws and bolts that kept them in place, but usually I had to go very roundabout on a long way to get to the back of each courtroom and go through the back, which was really difficult. And one of my assignments happened to be to our traffic court Bureau, which was in a neighboring building on the second floor, and unfortunately, there the elevator was broken. So after three days, I was actually received my first promotion, because they didn't know when it would be fixed. But eventually I was able to get into court, and I did a lot of litigation while I was   Michael Hingson ** 23:10 there. How did judges react to all of this?   Ken Kunken ** 23:15 You know, it was very new to them as well. And you know, there are times when you needed to approach the bench and talk very quietly, you know, to so the jury wouldn't hear you, and it was very difficult, because benches are elevated, yeah. And I had difficulty approaching the bench or even turning my head side enough to look up at the judges and then for them to hear me. And sometimes they would have to get off the bench, and, you know, meet me on the side of the courtroom to have conferences and but for the most part, I thought they were very supportive. I thought they appreciated the hard work that I was doing, and I think they tried to be accommodating when they could.   Michael Hingson ** 23:58 Did you ever encounter any that just were totally intolerant of all of it,   Ken Kunken ** 24:02 sure, you know, many of them were very impatient. Some of them had difficulty hearing and when I was trying to look up and talk to them without the jury hearing, some of them had trouble hearing me because, you know, they were much higher up than I was in my wheelchair. So it was very challenging.   Michael Hingson ** 24:23 I was involved in a lawsuit against an airline because they wouldn't allow me and my guide dog to sit where we wanted to sit on the airplane, which was in direct violation of even the rules of the airline. And when it went to court, the judge who was assigned it was a federal judge, and he was like 80, and he just couldn't hear anything at all. It was, it was really too bad. And of course, my and my wife was was with me, and of course, in her chair, so she wasn't sitting in a regular row. And he even grilled her, what are you doing? Why aren't you sitting in a row? And she said, I'm in a wheelchair. Oh, yeah, it's amazing that hopefully we are we have progressed a little bit from a lot of that the last thing. So, yeah, the lawsuit was 1985 so it was a long time ago, and hopefully we have progressed some. But still, there are way too many people who don't get it, and who don't understand nearly as much as they should, and don't internalize that maybe we're not all the same, and we can't necessarily do everything exactly the same every single time,   Ken Kunken ** 25:35 right? And you know, I had the added misfortune of having my injury 20 years before the Americans with Disabilities Act was passed, and that made an enormous difference for not just people in wheelchairs, but people with all different types of disabilities.   Michael Hingson ** 25:53 So how did you, in general, learn to deal with people's perceptions of you, rather than the reality? Well, that is a lot. Yeah, there are lots of perceptions, right?   Ken Kunken ** 26:07 You know, many people think that because you have a physical disability, that you must also have an intellectual disability. And people would often come into my room and wherever I was, whether it was when I was first in the hospital or later at the office and speak to the person next to me and ask them questions about me, as if I couldn't speak for myself, yeah, even as if I wasn't even there. And it took a while for me to be more outgoing and convince people that, yes, they can deal with me. You know, I can still talk and think. And I think whenever a jury came into the courtroom for the first time, I think they were very surprised to see the prosecutor as somebody with a disability who was sitting in an electric wheelchair.   Michael Hingson ** 26:56 I know once we went to a restaurant, and of course, having a family with two people in two different disabilities, went to this restaurant, and we were waiting to be seated, and finally, Karen said the hostess is just staring at us. She doesn't know who to talk to, because I'm not making eye contact, necessarily. And Karen, sitting in her chair is way lower. And so Karen just said to me, Well, this lady doesn't know who to talk to. So I said, Well, maybe we can get her to just ask us what what we want and what help we need. Are carrying on the conversation. Got this, this nice lady to recognize. Oh, you know, I can talk with them. And so she said, Well, how can I help you? And we both kind of said we'd like to sit and have breakfast. Oh, okay, and it went well from there. But it is, it is a challenge, and people have crazy perceptions, I know, going down the stairs at the World Trade Center on September 11, when I encountered the firefighters coming up for a while, they blocked me from going because they decided that I needed help, and they would, they would ask me questions, like, we're going to help you. Is that okay? And I said, No, it's not. But they always talked loud, because if you're blind, you obviously can't hear either, right? And it was difficult to get them to deal with all of that. And finally, I had to just say, Look, I got my friend David over here, who can see we're working together. We're fine, and they let us go because I had a sighted person with me, not that I had the ability to go downstairs, even though I had to help keep David focused sometimes, and also, there's no magic for a blind person to go downstairs. You know, you go down the stairs, you hold the rail, you turn left there, in this case, and you go down the next batch of stairs. But people don't recognize that. Maybe there are techniques that we use to deal with the same things that they deal with, only in a different way.   Ken Kunken ** 29:03 Absolutely, and that applies to work as well. I mean, people assume that if you can't do a job the way most people seem to do it, who don't have a disability, they automatically assume you're not going to be able to function at all at the job. Yeah, and a lot of times, it takes a lot of convincing to show people that there are other ways of approaching a problem and handling a work situation.   Michael Hingson ** 29:27 One of the common things that we as blind people face, and it happens in schools and so on, is, Oh, you don't need to learn braille that's outmoded. You can listen to books that are computer generated or recorded and so on. And the reality is, no we need to learn braille for the same reason the sighted people learn to read print, and that is, it's all about learning to spell. It's learning about sentence structure and so on, and it's learning about having better ways to be able to truly enter. Interact with the text as I tell people, I don't care what anyone says, you will not learn physics as well from recordings as you can by truly having access to everything in a braille book, because you can refer back easier, and they've done some improvements in recording, but it's still not the same as what you get when you do Braille, which is the same thing for you reading print, or any other sighted person reading print. You read that print because there are various reasons why you need to do that, as opposed to learning how to just listen to books recorded anyway,   Ken Kunken ** 30:36 right? Well, I had the added misfortune of being injured well before they had laptop   Michael Hingson ** 30:41 computers. Yeah, me too. Well, I yeah, not. I wasn't injured, but yeah,   Ken Kunken ** 30:46 right. So trying to do my schoolwork or later work at a job, you know, it posed even more challenges. Now, of course, having ebooks and being able to use a computer, it's made a big difference, not just for me, but for many individuals.   Michael Hingson ** 31:04 Sure, do you use like programs like Dragon Naturally Speaking to interact with the computer?   Ken Kunken ** 31:10 You know, I tried that, and I had a lot of difficulty with it. I know you need to train it. And when I first tried it, which was in its infancy, it just wasn't responding well to my voice, so I don't use that. I've been fortunate with that with advancements in wheelchairs, my wheelchair now has a Bluetooth device connected to my joystick, and I could actually move my left arm a little bit where I could work the joystick and move the mouse on my computer, moving my joystick. You   Michael Hingson ** 31:45 really might want to look into dragon again. It is just so incredibly different than it was years ago. I remember when Dragon Dictate first came out, and all of the challenges of it, but they have done so much work in developing the language models that it's it's a whole lot better than it used to be, and, yeah, you have to train it. But training isn't all that hard nowadays, even by comparison to what it was, and it gives you a lot of flexibility. And I am absolutely certain it would recognize your voice without any difficulty?   Ken Kunken ** 32:22 Well, it's good to hear that they've made those advancements,   Michael Hingson ** 32:26 and it's not nearly as expensive as it used to be, either. Well, that's good   Ken Kunken ** 32:30 to hear. I know when I first tried it, it was incredibly frustrating, yeah, because it wasn't responding well to my voice, and   Michael Hingson ** 32:38 it was like $1,500 as I recall, it was pretty expensive right now, it's maybe two or $300 and there's also a legal version of it and other things like that. Yeah, you really ought to try it. You might find it makes a big difference. It's worth exploring Anyway, okay, but be that as it may, so you you dealt with people's perceptions, and how did you, as you continue to encounter how people behave towards you, how did you keep from allowing that to embitter you or driving you crazy?   Ken Kunken ** 33:15 Well, you know, certainly at work, I needed to go in a jacket and tie, and I found that when you're wearing a jacket and tie, many people treated you differently than when you're just wearing street clothes. So I think that certainly helped that work. But I later became a supervisor in the district attorney's office, and people saw that, you know, not only could they talk with me on an intellectual level, but they saw I was supervising other assistant district attorneys, and I think that convinced a lot of people pretty quickly that I knew what I was doing and that they should treat me no different than they would any other lawyer, Assistant District Attorney.   Michael Hingson ** 33:59 Yeah, well, and it is projecting that confidence in a in a positive way that does make such a big difference,   Ken Kunken ** 34:08 absolutely. And I think when people saw me at work, one of the things that I appreciated was I never even needed to mention again that somebody with a disability could work, and not just at an entry level position, that a very responsible position. I was convinced them, just by showing them, without ever having to mention that somebody with a disability could do this kind of work.   Michael Hingson ** 34:35 I never bring it up unless it comes up, and a lot of times, especially when talking on the phone and so on, it never comes up. I've had times when people eventually met me, and of course, were themselves, somewhat amazed. I'm a blind person and all that I said, nothing's changed here, folks. The reality is that the same guy I was when you were just talking to me on the phone. So let's move forward. Word. And mostly people got it and and dealt with it very well.   Ken Kunken ** 35:08 Well, I used to have a lot of people, when they meet me for the first time, were very surprised to see that I was in a wheelchair. I never would say, Boy, you didn't sound like you were disabled. Yeah, right. And I think they were very surprised when they met me.   Michael Hingson ** 35:23 I've had some people who've said that to me, Well, you didn't sound blind on the telephone. And so depending on how snarky I feel or not, I might say, Well, what does a blind person sound like? And that generally tends to stop them, because the reality is, what does a blind person sound like? It doesn't mean anything at all, and it's really their attitudes that need to change. And I know as a keynote speaker for the last 23 years, just by doing the things that I do, and talking and communicating with people, it is also all about helping to change attitudes, which is a lot of fun.   Ken Kunken ** 36:03 You know, Michael, when I first went back to college, I was approached by a student on campus, and when he asked if I was Ken kunken, and I responded that I was, he asked, aren't you supposed to be in the hospital? Now, you know, I was very tempted to say yes, but I escaped. Please don't tell anyone. But you know, it even took a while to just show people, somebody with a disability does not need to be permanently in a rehab facility or a hospital or staying at home with their families, that there's an awful lot somebody could do and to be seen out in public and show people that you can work, you can go to school, you can do basically what everybody else does once you're given the opportunity.   Michael Hingson ** 36:55 Of course, being spiteful, my response would have been, well, yeah, I should still be in the hospital doing brain surgery, but I decided that I didn't want to be a doctor because I didn't have any patients, so I decided to take a different career, right? Oh, people, yeah, what do you do? And we all face it, but the reality is, and I believe very firmly and have have thought this way for a long time, that like it or not, we're teachers, and we do need to teach people, and we need to take that role on, and it can be difficult sometimes, because you can lose patience, depending on what kind of questions people ask and so on. But the reality is, we are teachers, and our job is to teach, and we can make that a very fun thing to do as we move forward, too.   Ken Kunken ** 37:44 You know, Michael, I found most people really want to be helpful. Yeah, a lot of times they don't know how to be helpful or how to go about it, or what to say or what to do, but most people are really good people that want to help. And you know, the more they come in contact with somebody with a disability, the more comfortable they will feel   Michael Hingson ** 38:04 right, and they'll learn to ask if you want help, and they won't make the assumption, which is, of course, the whole point.   Ken Kunken ** 38:14 You know, Michael, when you leave the job the district attorney's office, you would go through what they call an exit interview, where they would ask you what you thought was the best part of the job, what you thought could be improved. And I'm so happy and proud to say that I was told that a number of assistant district attorneys said that one of the best parts of their job was meeting and getting to know and working with me. And the reason why I wanted to highlight that was I know they weren't talking about me being Ken kunken, but me being somebody with a disability. Because unless they had a close relative with a disability, people rarely came in daily contact with somebody with a disability, and for them, it was often a revelation that they found helped motivate and inspire them to work harder in their job, and they were very appreciative of that,   Michael Hingson ** 39:12 but they also learned that the disability wasn't what defined you. What defined you was you and your personality and what you did not necessarily exactly how you   Ken Kunken ** 39:24 did it, absolutely. And I think it was also a revelation that working with me did not involve additional work for them, right? I was able to carry my own weight, and often was more productive than many of the people I was working with. Right?   Michael Hingson ** 39:42 Well, and I think that's a very crucial point about the whole thing. When you became a lawyer, did that change your view of yourself? I mean, I know it was a kind of an evolution that got you to being a lawyer. But how did becoming a lawyer and when go. Answer, and getting the law degree and then working in a law office. How did that change your perceptions and your attitudes and outlook?   Ken Kunken ** 40:06 You know, it really changed it a great deal, because I had people look at me with a very different eye when they were looking at me. You know, I enjoyed my work as a vocational rehabilitation counselor very much. And I encourage people to do that work. But I felt that there were people that looked at me and thought, you know, he has a disability. Maybe he could only work with other people had disabilities. And I was very proud of the fact that when I became a lawyer, I was working with very few people that had disabilities. Most of them were able bodied. And I wanted to show people that you're not limited in any way with who you're going to work with and what you could do. And I think it's so important for people to keep their perceptions high, their expectations high when they're dealing with individuals, because just because somebody has a disability does not mean they cannot perform and do as much as virtually anybody else on the job   Michael Hingson ** 41:14 well, and you clearly continue to have high expectations of and for you, but also I would suspect that the result was you had high expectations for those around you as well. You helped them shape what they did, and by virtue of the way you functioned, you helped them become better people as well.   Ken Kunken ** 41:38 Well, I certainly tried to and from the feedback that I've gotten from many of the people I worked with, that seemed to be the case, and I'm very proud of that. In fact, I might add Michael that two years ago, the district attorney, now her name is Ann Donnelly, actually started an award in the district attorney's office that's given out annually that they named the Kenneth J kunken award. They named it for me because they wanted to recognize and honor the outstanding Assistant District Attorney each year who displayed the work ethic and the loyalty and devotion to the office as well the person in the wheelchair, right? And I'm very proud of that,   Michael Hingson ** 42:25 but I will bet, and I'm not trying to mitigate it, but I will bet that mostly that award came about because of the things that you did and your work ethic, and that the wheelchair aspect of it was really somewhat second nature. And far down the list,   Ken Kunken ** 42:41 I'm very proud of the fact that that seems to be the case and and one of the aspects of that award was they talked about the effect that I had on my colleagues, and the beneficial effect that that was Yeah,   Michael Hingson ** 42:56 because the reality is, it ultimately comes down to who you are and what you do and and I'm not, and again, I'm not mitigating being in a wheelchair or having any kind of disability, but I really, truly believe ultimately the disability isn't what is not what defines us, it's how we are and what we do and how we behave in society that really will be what helps us make a mark on whatever we're involved with,   Ken Kunken ** 43:28 right? And I think for some, as I say, it was a revelation to see that somebody with a disability had the same needs, wants and desires as everybody else. We were certainly no different with respect to that right.   Michael Hingson ** 43:43 So how long did you work as a lawyer and in the district attorney's office?   Ken Kunken ** 43:49 Well, I worked there full time for more than 33 years, and then I worked there in a part time capacity for an additional eight years. So all told, more than 40 years I worked there, and in fact, I'm one of the longest serving Nassau County assistant district attorneys that they've ever had.   Michael Hingson ** 44:09 Now, why did you go back to part time after 33 years?   Ken Kunken ** 44:15 Well, there are a number of reasons. You know, I I thought that due to some health issues, I wanted to play it safe and make sure that I locked in my pension, because I thought there would be a bigger payout if I retired while I was still working than if I died while I was working on the job. As it turned out, my health issue seemed to resolve itself, but I decided that, you know, retiring, when I did, gave me some more time to spend at home with my family, and I really appreciated being able to do that.   Michael Hingson ** 44:53 That's a very admirable thing. Can't complain about that. So what keeps you going?   Ken Kunken ** 45:00 What keeps me going now is my family. Just so your listeners know, I'm married to the wonderful woman that's actually sitting to my right right now. My name is Anna, and we're actually the parents of triplet sons. We have three incredible boys, Joseph, James and Timothy. They're now 20 years old, and they're currently sophomores at three separate colleges in upstate New York, and they're the light of my life. I couldn't be more proud. And they're what keeps me going these days.   Michael Hingson ** 45:33 What colleges?   Ken Kunken ** 45:36 Well, James is going to the State University of New York at Morrisville, where he's studying renewable energy. Timothy is pursuing a dual major at the SI Newhouse School of Communications in the Maxwell School of Public Policy at Syracuse University. And my son Joseph is actually attending my alma mater, Cornell University, where he's majoring in mechanical engineering.   Michael Hingson ** 46:06 And do they all go watch football games on the weekend? I mean, given the fact that least a couple of those are at schools with good football   Ken Kunken ** 46:13 teams, right? But you know what? They never wanted anything to do with football. But they are all physically active, in great shape, and in fact, all of them have pursued the martial arts, and all three of them are second degree black belts in Taekwondo. And they've all even worked as instructors in the Taekwondo studio here in Long Island.   Michael Hingson ** 46:35 So dad has to be careful, though they'll take you out, huh?   Ken Kunken ** 46:39 You bet. In fact, I've got my own three personal bodyguards when   Michael Hingson ** 46:43 I got right, you can't do better than that. And and Anna, which I'll bet is more formidable than all of them   Ken Kunken ** 46:53 on, is incredible. I mean, she is just a force that is unstoppable. She's incredible.   Michael Hingson ** 47:01 Well, that's cool all the way around, and it's, it's great that you, you have a good neighborhood around you to support you, and I think we all need that. That's that's pretty important to to deal with. So with your job and all that, now that you are retired, I don't know whether you have much stress in your life, but how do you deal with stress? And how does stress affect you and or does it make any difference with a disability?   Ken Kunken ** 47:30 It sure does. It's an interesting question, because before my injury, one of the ways I would deal with stress would be out of the football field, yeah, you know, being physically active, running into an individual, you know, to tackle or block, that was a great way to relieve some of my stress. Once I had my injury, I no longer had that outlet, so I had to find different ways of dealing with it. One of my ways was, you know, trying to sit outside and sit in the garden or by water and, you know, just enjoy nature and try and relax and clear my mind. But now my best stress relievers are my three children. I'm spending time with them, watching all that they're doing. I find that the best way of me to be able to relax and relieve any anxieties that I have?   Michael Hingson ** 48:23 Well, I think there's a lot of value in doing things that keep you calm and focused. I think that is the best way to deal with stress. All too often, we don't think or be introspective about ourselves and our lives, and we don't really step back and get rid of that stress mentally, and that's where it really all comes from. I mean, I know people have physical manifestations of stress and so on, but I would submit that typically, stress is so much more an emotional thing because we haven't learned how to deal with it, and you clearly have   Ken Kunken ** 49:02 it took a while, but yeah, now I have my family to help every step of the way, and that includes relieving the stress that I've under.   Michael Hingson ** 49:10 Yeah, and stress is important to get rid of and not have around. It will help you live a whole lot longer not to have stress I just went through a week ago and op was, you know, an operation to change a heart valve. And people keep asking me, well, Weren't you worried? Weren't you stressed over that? And my answer was, No, I had no control over it really happening to my knowledge, I don't think that I've been a very poor eater, and all of my arteries and everything were good. And so no, I wasn't stressed, even when I first learned that there was an issue and wasn't an emergency room for over 24 hours, mostly sitting around, I chose not to be stressed, and it was a choice. And so I just listened to things around me and became quite entertained at some of the people. People who were in the emergency room with me, but being stressed wasn't going to do anything to help the process at all. So I refuse to get stressed.   Ken Kunken ** 50:09 That's great. And you know, I think this finally retiring has helped me deal with stress as well, because working as an assistant district attorney, there can be a lot of stressful situations in the office, and it's, it's nice to finally be retired and be able to enjoy all of my activities outside of the office.   Michael Hingson ** 50:33 What would you say is probably the most stressful thing that you had to endure as an attorney? You were, I mean, you did this for 40 years, or almost 40 years? So what? Well, actually, yeah, for 40 years. So what would you say is the most stressful thing that you ever had to deal with?   Ken Kunken ** 50:50 Well, I had to rely on, you know, my memory, because it was difficult for me even turning pages of a book or pulling, you know, pieces of paper out of a file, and there was a lot of paperwork that you get to be familiar with, whether they be grand jury testimony or prior witness statements. And I had to rely a lot of my memory and through the help of student interns or paralegals or secretaries, and it was very difficult. And I might add, you know, just to give you one anecdote, one day after I had convicted a defendant of, you know, felony, you know, he was a person with a lot of prior involvement with the criminal justice system, and I was about to go down for his sentencing, he jumped in the elevator with me, and now we're alone in the elevator riding down, and here I am with this person that I convicted of a serious case, and I'm about to recommend that he go to an upstate prison. And he approaches me and says, I have a proposition for you. If you don't send me to jail, I'll agree to work as your personal care attendant for a year, which really struck me as odd. I mean, he must have thought that working for me for a year would be the equivalent of going to prison for a few years. But fortunately, the elevator door opened and I politely turned down his request and went to court, and he was sentenced to two to four years in an upstate prison.   Michael Hingson ** 52:28 Still was creative,   52:30 right?   Michael Hingson ** 52:33 So in all of your life and all the things you've done, what are you most proud   Ken Kunken ** 52:36 of, well, but definitely most proud of my family life? I mean, as I indicated, I'm married now, married for more than 21 years now, my three boys are sophomores in college and doing absolutely great, and make me proud every single day. But I'm proud of the fact that I was able to go back to school, complete my education and work at a job and earn a living where I was able to support myself and able to purchase a house and live now with my wife and children and lead as just about as normal a life as any other family would lead.   Michael Hingson ** 53:18 Now being married to Ana is that your first marriage? It sure is. So there we go. Well, I hear you and but you guys met late, and I'm going to step out on a limb and say it proves something that I've always felt, which is, you'll get married when the right person comes along, especially if you're mature enough to recognize it,   Ken Kunken ** 53:41 you're right. And I was very fortunate that the right person came along in my life, and we have a very happy marriage that I cannot picture life without him right now,   Michael Hingson ** 53:56 my wife and I got married when I was 32 she was 33 but we knew what we wanted in a partner, and when we first met each other, it just sort of clicked right from the beginning. We met in January of 1982 and in July, I asked her to marry me, and we got married in November of 1982 and so we were married for 40 years before she passed. And you know, there are always challenges, but, but you deal with it. So it must have been really an interesting time and an interesting life, suddenly discovering you have three boy triplets.   Ken Kunken ** 54:31 You know, it really was well, you know, when I decided to get married, she told me that she wanted to have my baby, and not just any baby my baby, she said she wanted to see a little pumpkin running around our home. And this really seemed impossible at the time. I had been paralyzed for more than 30 years, and I was already in my 50s, but we looked into various options, including in vitro fertilization and. And we're very excited, excited to learn we could still, I could still father a child. So we pursued it. And you know, through good fortune, good luck, and I guess somebody smiling on us from above, Anna became pregnant with triplets, and I couldn't be happier to have these three wonderful boys in my life.   Michael Hingson ** 55:21 So did becoming a father change you? Or how did you evolve? When that all happened,   Ken Kunken ** 55:26 it sure did. I mean, you know, it went from me being number one in honors life to suddenly being number four after all, three boys got the attention they needed, but it was wonderful for me to be able to help shape their lives and guide them so that they would develop the right character and values and learn the importance of helping others throughout their lives, which they do, and It's I think it's made me a better person, being able to help and guide them. That's cool.   Michael Hingson ** 56:07 Well, the the other thing I would ask is, if you had a chance to go back and talk to a younger Ken, what would you say? What would you teach them so that they would maybe make mistakes that you made?   Ken Kunken ** 56:18 Well, I'd say there's an awful lot you could still do in life, even without your physical movement, and sometimes it takes a lot of patience and a lot of self reflection, but to realize there's an awful lot you can do and that they need to keep their expectations high for themselves as well as for others, and to realize that just because something has not been done before doesn't mean they cannot do it now. They've got to find different ways of approaching problems and handling it and developing some self confidence in themselves and their ability to deal with difficult situations.   Michael Hingson ** 57:03 How did the Americans with Disabilities Act improve all that you did and make your life, especially on the job, better?   Ken Kunken ** 57:12 Well, it, you know, made facilities so much more accessible. When I first went back to college, there was not one ramp or curb cut on the entire campus. On my first day back in school, I had to be either pulled up or bounced down close to 100 steps just to attend my classes, and as I indicated, in the DAs office, I couldn't even fit through the swinging doorways to get in the courtroom. So it made it tremendously easier to not have to deal with all the physical challenges, but it also made it better for dealing with other people and their attitudes about dealing with people with disabilities, because thanks to the Americans with Disabilities Act, you see more people with disabilities out in public. So people are more used to seeing, dealing, interacting with people, and seeing what they can do and that they're just like everybody else. And as a result, people's attitudes have been changing, and I think that's helped me as well, in many different ways.   Michael Hingson ** 58:20 Cool, well, you have written a book about all of this. Tell me about the book.   Ken Kunken ** 58:27 Okay, I actually started writing a book when I was still in the rehab facility. Not long after I was hurt, a friend of my aunt Lorraine's by the name of Albert meglan visited me in the hospital and thought that one it may help me deal with my depression by talking about what I was going through, but also inform other individuals what a spinal cord injury was like and what's involved with rehabilitation. So he used to visit me in the rehab facility one day a week for a number of weeks for me to start writing a book about my experiences. And then when I went back to school, I started working on it on my own, but I would pick it up and stop and start and stop again over the course of 50 years. And then once I retired, I had more time to sit down with my wife, and I would dictate to her, and she would type it on her laptop computer until we finally finished my memoir, which is called I dream of things that never were, the Ken kunken story, and it's published by a company called 12 tables Press, and they could learn more about my book by going on my website, which is kenkunkin.com and I might add that where I got the title of my book was six months after my injury. I was asked to testify before a United States Health subcommittee chaired by Senate. Senator Edward Kennedy. And eight days after my testimony, Senator Kennedy sent me a glass paperweight in the mail that had an inscription on it that the senator said his late brother Robert Kennedy liked very much. And the inscription read, some men see things as they are and say, Why I dream of things that never were. And say, why not? And that's where I got the title of my book. I dream of things that never were.   Michael Hingson ** 1:00:28 Yeah, that's cool. And where can people get the book?   Ken Kunken ** 1:00:35 Well, it's available on Amazon. It's also available at the Cornell bookstore, and if they go on my website, Ken kunken.com spellkin For me, please. It's K U N, as in Nancy. K e n that tells of a number of ways that they could purchase the book, both the hardcover book, it's also available as a Kindle version as an e book, and just recently, we put it out as an audio book as well. And they could learn all about it by going to the website, but certainly it's available on Amazon. If they wanted to order in bulk, they could contact my publisher directly, and he could help them fulfill that type of order. Cool.   Michael Hingson ** 1:01:22 That is great. So now the real question is, are there any more books in Ken to come out?   Ken Kunken ** 1:01:28 Well, this book took me 50 years to I know you got to go a little bit faster. So no, I think I wrote down everything that I wanted to convey to people in that book, and now I'm actively just promoting the book like you. I've spoken at a number of different events as a motivational speaker, and you know, the book has given me a way to get m

Bill McIntyre talks with Mr. Scott Davis, Nassau County Legislator representing the newly formed First Legislative District, which is comprised of the Village of Rockville Centre and a majority of the Village of Hempstead.  They speak about the recently approved budget for Nassau Community College, Capital Funding in the County, the latest on Nassau University Medical Center, and more.

This is the noon All Local for Thursday, June 26, 2026

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Summary In this episode of the Pain Exam Podcast, Dr. David Rosenblum provides a comprehensive review of herpes zoster and postherpetic neuralgia (PHN), focusing on pathophysiology, diagnosis, and treatment options. Dr. Rosenblum explains that postherpetic neuralgia affects approximately 25% of patients with acute herpes zoster, causing debilitating unilateral chronic pain in one or more dermatomes. He discusses the three phases of herpes zoster: acute (up to 30 days), subacute (up to 3 months), and postherpetic neuralgia (pain continuing beyond 3 months). Dr. Rosenblum identifies risk factors for developing PHN, including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. He details the pathophysiology involving peripheral and central sensitization, and explains different phenotypes of PHN that can guide treatment approaches. For treatment, Dr. Rosenblum reviews various options including antiviral medications (which should be started within 72 hours of onset), corticosteroids, opioids, antidepressants (particularly tricyclics and SNRIs), antiepileptics (gabapentin and pregabalin), topical agents (lidocaine and capsaicin), and interventional procedures such as epidural injections and pulsed radiofrequency. He emphasizes that prevention through vaccination with Shingrix is highly effective, with 97% effectiveness in preventing herpes zoster in patients 50-69 years old and 89% effectiveness in those over 70. Dr. Rosenblum mentions that he's currently treating a patient with trigeminal postherpetic neuralgia and is considering a topical sphenopalatine ganglion block as a minimally invasive intervention before attempting more invasive procedures. Chapters Introduction to the Pain Exam Podcast and Topic Overview Dr. David Rosenblum introduces the Pain Exam Podcast, mentioning that it covers painful disorders, alternative treatments, and practice management. He explains that this episode focuses on herpes zoster and postherpetic neuralgia as board preparation for fellows starting their programs, with ABA boards coming up in September. Dr. Rosenblum notes that he's not only preparing listeners for boards but also seeking the latest information to help treat his own patients with this notoriously difficult disease. Upcoming Conferences and Educational Opportunities Dr. Rosenblum announces several upcoming conferences including Aspen in July, Pain Week in September, and events with NYSIP and the Latin American Pain Society. He mentions he'll be teaching ultrasound and regenerative medicine at these events. Dr. Rosenblum invites listeners to sign up at nrappain.org to access a community discussing regenerative medicine, ultrasound-guided pain medicine, regional anesthesia, and board preparation. He also offers ultrasound training in New York and elsewhere, with upcoming sessions in Manhattan on July 12th and October 4th, plus private shadowing opportunities. Overview of Postherpetic Neuralgia Dr. Rosenblum defines postherpetic neuralgia as typically a unilateral chronic pain in one or more dermatomes after acute herpes zoster infection. He states that the incidence of acute herpes zoster ranges between 3-5 patients per thousand person-years, and one in four patients with acute herpes zoster-related pain will transition into postherpetic neuralgia. Dr. Rosenblum emphasizes that while this condition won't kill patients, it can be extremely debilitating and significantly reduce quality of life. Treatment Options Overview Dr. Rosenblum reviews treatment options according to the WHO pain ladder, including tricyclics like nortriptyline and antiepileptic drugs such as gabapentin. He explains that if pain is not significantly reduced, interventional treatments like epidural injections with local anesthetics and corticosteroids or pulsed radiofrequency of the dorsal root ganglion are options. For postherpetic neuralgia specifically, Dr. Rosenblum notes that preferred treatments include transdermal capsaicin, lidocaine, or oral drugs such as antidepressants or antiepileptics. Phases of Herpes Zoster and Definitions Dr. Rosenblum outlines the three phases during herpes zoster reactivation: acute herpes zoster-related pain (lasting maximum 30 days), subacute herpes zoster-related pain (pain after healing of vesicles but disappearing within 3 months), and postherpetic neuralgia (typically defined as pain continuing after 3 months). He mentions that acute herpes zoster pain often begins with prodromal pain starting a few days before the appearance of the rash. Incidence and Risk Factors Dr. Rosenblum states that the incidence of herpes zoster ranges between 3-5 patients per 1,000 person-years, with approximately 5-30% of cases leading to postherpetic neuralgia. He identifies risk factors including older age, female sex, immunosuppression, prodromal pain, severe rash, and greater acute pain severity. Dr. Rosenblum describes the clinical manifestations as a mosaic of somatosensory symptoms including burning, deep aching pain, tingling, itching, stabbing, often associated with tactile and cold allodynia. Impact on Quality of Life Dr. Rosenblum emphasizes that postherpetic neuralgia can be debilitating, impacting both physical and emotional functioning and causing decreased quality of life. He notes that it leads to fatigue, insomnia, depression, anorexia, anxiety, and emotional distress. Dr. Rosenblum stresses the importance of exploring methods for prevention of postherpetic neuralgia and optimizing pain treatment for both subacute herpes zoster-related pain and postherpetic neuralgia. Literature Review and Pathophysiology Dr. Rosenblum mentions that he's discussing a literature review from 2024 that updates previous practical guidelines published in 2011. He explains the pathophysiology of postherpetic neuralgia, which involves sensitization of peripheral and sensory nerves from damage. Dr. Rosenblum describes how inflammatory mediators reduce the stimulus threshold of nociceptors and increase responsiveness, resulting in pathological spontaneous discharges, lower thresholds for thermal and mechanical stimuli, and hyperalgesia. Central Sensitization and Nerve Damage Dr. Rosenblum explains that central sensitization results from peripheral nociceptor hyperactivity leading to plastic changes in the central nervous system, involving amplification of pain signals and reduced inhibition. He describes how nerve damage in postherpetic neuralgia patients results from neuronal death due to severe inflammatory stimuli or secondary to neuronal swelling. Dr. Rosenblum notes that motor defects occur in 0.05% of patients with herpes zoster, observed as abdominal pseudohernias or motor weakness of limbs limited to the affected myotome. Different Phenotypes and Classification Dr. Rosenblum discusses different phenotypes of postherpetic neuralgia and how phenotyping can determine treatment. He explains that there are several ways to classify the phenotypes, with one categorizing patients into three subtypes: sensory loss (most common), thermal gain, and thermal loss with mechanical gain. Dr. Rosenblum describes the mechanistic categorization, including the irritable nociceptive phenotype characterized by preserved sensation, profound dynamic mechanical allodynia, reduced pressure pain threshold, and relief with local anesthetic infiltration. Deafferentation Phenotype Dr. Rosenblum explains that a deafferentation phenotype may arise from destruction of neurons by the virus in the dorsal root ganglion. This phenotype is characterized by sensory loss, including thermal and vibratory sensation without prominent thermal allodynia. He notes that mechanical allodynia can occur secondary to A-beta fibers activating spinothalamic pathways (known as phenotypic switches), along with pressure hyperalgesia and temporal summation suggesting central sensitization. Dr. Rosenblum mentions that in one study, this phenotype was present in 10.8% of individuals, and for those with deafferentation pain, gabapentinoids, antidepressants, and neuromodulatory therapies like repetitive transcranial magnetic stimulation may be beneficial. Diagnosis and Physical Examination Dr. Rosenblum discusses the diagnosis of herpes zoster and postherpetic neuralgia, emphasizing the importance of physical examination. He explains that diagnosis is based on the rash, redness, papules, and vesicles in the painful dermatomes, with healing vesicles showing crust formation. Dr. Rosenblum notes that the rash is generally unilateral and does not cross the midline of the body. In postherpetic neuralgia patients, he mentions that scarring, hyper or hypopigmentation is often visible, with allodynia present in 45-75% of affected patients. Sensory Testing and Assessment Dr. Rosenblum explains that in patients with postherpetic neuralgia, a mosaic of somatosensory alterations can occur, manifesting as hyperalgesia, allodynia, and sensory loss. These can be quantified by quantitative sensory testing, which assesses somatosensory functions, dermal detection thresholds for perception of cold, warmth, and paradoxical heat sensations. He notes that testing can provide clues regarding underlying mechanisms of pain, impaired conditioned pain modulation, temporal summation suggesting central sensitization, and information about the type of nerve damage and surviving afferent neurons. Prevention Through Vaccination Dr. Rosenblum discusses prevention of acute herpes zoster through vaccination, noting that the risk increases with reduced immunity. He highlights studies evaluating Shingrix, a vaccine for herpes zoster, which showed 97% effectiveness in preventing herpes zoster in patients 50-69 years old with healthy immune systems and 89% effectiveness in patients over 70. Dr. Rosenblum states that Shingrix is 89-91% effective in preventing postherpetic neuralgia development in patients with healthy immune systems and 68-91% effective in those with weakened or underlying conditions. Treatment Objectives Dr. Rosenblum outlines the treatment objectives for herpes zoster and postherpetic neuralgia. For acute herpes zoster, objectives include relieving pain, reducing severity and duration of pain, accelerating recovery of epidermal defects, and preventing secondary infections. For postherpetic neuralgia, the objectives are pain alleviation and improved quality of life. Dr. Rosenblum lists available treatments including psychotherapy, opiates, antidepressants, antiepileptics, NMDA antagonists, topical agents, and interventional treatments such as epidurals, pulsed radiofrequency, nerve blocks, and spinal cord stimulation. Antiviral Medications Dr. Rosenblum emphasizes that antiviral drugs should be started within 72 hours of clinical onset, mentioning famciclovir, valacyclovir, and acyclovir. He notes there is no evidence for effectiveness after 72 hours in patients with uncomplicated herpes zoster. Dr. Rosenblum provides dosing information: for immunocompetent patients, famciclovir 500mg and valacyclovir 1000mg three times daily for seven days; for immunocompromised patients, famciclovir 1000mg three times daily for 10 days, while acyclovir should be given IV in the immunocompromised. Benefits of Antiviral Therapy Dr. Rosenblum explains that antiviral medication accelerates the disappearance of vesicles and crusts, promotes healing of skin lesions, and prevents new lesions from forming. By inhibiting viral replication, he notes that antiviral therapy likely reduces nerve damage, resulting in reduced incidence of postherpetic neuralgia, and should be started as soon as possible. Corticosteroids and Opioids Dr. Rosenblum discusses the use of corticosteroids, noting that when added to antiviral medications, they may reduce the severity of acute herpes zoster-related pain, though increased healing of skin lesions was not observed in one study. He mentions that a Cochrane review found oral corticosteroids ineffective in preventing postherpetic neuralgia. Regarding opioids, Dr. Rosenblum states they are commonly used alongside antivirals for controlling acute herpes zoster pain, with tramadol having a number needed to treat (NNT) of 4.7 and strong opioids having an NNT of 4.3 for 50% pain reduction. Methadone and Antidepressants Dr. Rosenblum discusses methadone as an NMDA receptor antagonist used in acute and chronic pain management, though he notes there are no randomized controlled trials determining its efficacy in acute herpes zoster pain or postherpetic neuralgia. He explains that methadone can modulate pain stimuli by inhibiting the uptake of norepinephrine and serotonin, resulting in decreased development of hyperalgesia and opioid tolerance, but has side effects including constipation, nausea, sedation, and QT prolongation that can trigger torsades de pointes. Dr. Rosenblum identifies antidepressants as first-line therapy for postherpetic neuralgia, including tricyclics and SNRIs, with tricyclics having an NNT of 3 and SNRIs an NNT of 6.4 for 50% pain reduction. Antiepileptics and Pharmacological Treatment Summary Dr. Rosenblum discusses antiepileptics like gabapentin and pregabalin for postherpetic neuralgia. He cites two trials measuring gabapentin's effect, concluding it was effective compared to placebo with a pooled NNT of 4.4, while pregabalin had an NNT of 4.9. Dr. Rosenblum summarizes that pharmacological treatment is well established for subacute herpes zoster pain, though new high-quality evidence has been lacking since the last update in 2011. Topical Agents Dr. Rosenblum discusses local anesthetic topical agents including lidocaine and capsaicin creams and patches. He notes that 8% capsaicin provided significant pain reduction during 2-8 weeks, while 5% lidocaine patches provided moderate pain relief after eight weeks of treatment. Dr. Rosenblum also mentions acute herpes zoster intracutaneous injections, citing a study where single intracutaneous injection with methylprednisolone combined with ropivacaine versus saline alone showed significant difference in VAS score at 1 and 4 weeks post-intervention favoring the intervention group. Intracutaneous Injections Dr. Rosenblum discusses the effect of repetitive intracutaneous injections with ropivacaine and methylprednisolone every 48 hours for one week. He cites a randomized control trial comparing antivirals plus analgesics to antivirals plus analgesics and repeat injections, finding the intervention group had significantly shorter duration of pain, lower VAS scores, and lower incidence of postherpetic neuralgia (6.4% vs 28% at 3 months). Dr. Rosenblum notes that a potential side effect of cutaneous methylprednisolone injection is fat atrophy, though this wasn't reported in the study. Summary of Local Anesthetics Dr. Rosenblum summarizes that there are no new studies reporting the efficacy of capsaicin 8% for postherpetic neuralgia, but it remains widely used in clinical practice and is approved in several countries. He notes that lidocaine patches can reduce pain intensity in patients with postherpetic neuralgia but may be more beneficial in patients with allodynia. Dr. Rosenblum adds that intracutaneous injections may be helpful for short periods, while repetitive injections with local anesthetics may reduce VAS scores for up to six months but can cause subcutaneous fat atrophy. Interventional Treatments: Epidural and Paravertebral Injections Dr. Rosenblum discusses interventional treatments, noting that previous guidelines found epidural injection with corticosteroids and local anesthetic as add-on therapy superior to standard care alone for up to one month in managing acute herpes zoster pain. He mentions a randomized controlled trial showing no difference between interlaminar and transforaminal epidural steroid injections for up to three months after the procedure. Dr. Rosenblum adds that previous guidelines reported high-quality evidence that paravertebral injections of corticosteroids or local anesthetic reduces pain in the active phase of herpes zoster. Comparative Studies on Injection Approaches Dr. Rosenblum discusses a trial comparing efficacy of repetitive paravertebral blocks with ropivacaine versus dexmedetomidine to prevent postherpetic neuralgia, which showed significantly lower incidence of zoster-related pain one month after therapy in the dexmedetomidine group, with effects still significant at three months. He also mentions a study comparing steroid injections administered via interlaminar versus transforaminal approaches, finding both groups had significantly lower VAS scores at 1 and 3 months follow-up compared to baseline, though this could align with the natural course of herpes zoster. Timing of Interventions and Continuous Epidural Blockade Dr. Rosenblum cites a retrospective study showing that transforaminal epidural injections administered for acute herpes zoster-related pain were associated with significantly shorter time to pain relief compared to those performed in the subacute phase. He also mentions a randomized controlled trial finding that continuous epidural blockade combined with opioids and gabapentin reduced NRS pain scores more than analgesic drug treatments alone during three-day follow-up, though both studies were low-quality. Interventions for Postherpetic Neuralgia Dr. Rosenblum discusses interventions specifically for postherpetic neuralgia, citing a small randomized controlled trial that demonstrated decreased NRS pain scores six months post-treatment for repeat versus single epidural steroid injections (15mg vs 5mg dexamethasone) administered over 24 days. The trial also found increased likelihood of complete remission during 6-month follow-up in the group receiving repeat epidural dexamethasone, though this was low-quality evidence. Summary of Epidural and Paravertebral Injections Dr. Rosenblum summarizes that epidural or paravertebral injections of local anesthetic and/or glucocorticoids could be considered in treating acute herpes zoster-related pain. For subacute postherpetic neuralgia pain, he notes low-quality evidence supporting epidural injections, while for postherpetic neuralgia, evidence supports continuous epidural infusion, though also of low quality. Dr. Rosenblum emphasizes that none of the included studies for postherpetic neuralgia investigating epidural or paravertebral injections resulted in decreased pain compared to standard therapy. Pulsed Radiofrequency (PRF) Evidence Dr. Rosenblum discusses pulsed radiofrequency (PRF), noting that previous guidelines indicated moderate quality evidence that PRF of the intercostal nerve reduces pain for 6 months in patients with postherpetic neuralgia, and very low-quality evidence that PRF to the dorsal root ganglion (DRG) reduces pain for 6 months. He mentions that multiple studies have been published since then assessing PRF efficacy. PRF Studies for Acute Herpes Zoster Dr. Rosenblum discusses a randomized controlled trial with 60 patients comparing high-voltage bipolar PRF of the cervical sympathetic chain versus sham, with treatment repeated after three days in both groups. He reports that VAS scores in the PRF group at each post-interventional point (1 day, 2 days, 1 month, 2 months, 3 months) were significantly lower than in the sham group, and at 3 months, the incidence of postherpetic neuralgia was 16.7% in the PRF group compared to 40% in the sham group. PRF for Trigeminal Neuralgia Dr. Rosenblum cites another randomized controlled trial evaluating high-voltage long-duration PRF of the Gasserian ganglion in 96 patients with subacute herpes-related trigeminal neuralgia, which found decreased VAS pain scores at all post-interventional time points (3, 7, 14 days and 1, 3, and 6 months) compared to the sham group. He also mentions a randomized comparative effectiveness study in 120 patients with subacute trigeminal herpes zoster, comparing a single application of high-voltage PRF to the Gasserian ganglion versus three cycles of conventional PRF treatment, finding significantly lower mean VAS pain scores for up to six months in the high-voltage PRF group. PRF Compared to Other Interventions Dr. Rosenblum discusses a randomized controlled trial comparing PRF to short-term spinal cord stimulation, which found decreased pain and improved 36-item short-form health survey scores in both groups at six months. He also mentions a randomized controlled trial in 72 patients where PRF of spinal nerves or peripheral branches of cranial nerves combined with five-day infusion of IV lidocaine resulted in greater pain reduction, less rescue analgesia, and reduced inflammatory cytokines at two months compared to PRF with saline infusions. Dr. Rosenblum notes a major limitation of this study was not accounting for the high natural recovery rate. Summary of PRF and Final Recommendations Dr. Rosenblum summarizes that PRF provides significant pain relief lasting over three months in patients with subacute herpes zoster and postherpetic neuralgia. He notes that since few studies have compared PRF versus sham, it's not possible to calculate an accurate number needed to treat. Dr. Rosenblum mentions there are no comparative studies comparing PRF to the intercostal nerves versus PRF of the DRG, but both preclinical and clinical studies suggest superiority of the DRG approach. He adds that evidence for spinal cord stimulation for postherpetic neuralgia is of low quality, and more research is needed given its invasive nature. Sympathetic Blocks and Conclusion Dr. Rosenblum notes there is low-quality evidence for using sympathetic blocks to treat acute herpes zoster-related pain, but no evidence for their use in postherpetic neuralgia. He mentions that risks of treatment with intrathecal methylprednisolone are unclear and therefore not recommended. Dr. Rosenblum concludes by praising the comprehensive article he's been discussing and mentions it provides insight for treating his patients, including a recent case of trigeminal postherpetic neuralgia. Personal Clinical Approach and Closing Dr. Rosenblum shares that he doesn't currently perform PRF in his practice, partly because it's not standard of care and not well reimbursed, creating barriers to implementation. However, he notes that PRF is a very safe procedure as it doesn't involve burning tissue. For his patient with trigeminal neuralgia pain, Dr. Rosenblum plans to try a topical sphenopalatine ganglion block as the least invasive intervention before considering injecting the trigeminal nerves at the foramen, in addition to pharmacotherapy. He concludes by thanking listeners, encouraging them to check the show notes and links, mentioning institutional memberships and shadowing opportunities, and asking listeners to rate and share the podcast. Q&A No Q&A session in this lecture Pain Management Board Prep   Ultrasound Training REGISTER TODAY!   Create an Account and get Free Access to the PainExam- NRAP Academy Community Highlights     David Rosenblum, MD, currently serves as the Director of Pain Management at Maimonides Medical Center and AABP Integrative Pain Care.  As a member of the Department of Anesthesiology, he is involved in teaching, research, CME activities, and was key faculty in developing the anesthesiology residency's regional anesthesia block rotation, as well as institutional wide acute and chronic pain management protocols to ensure safe and effective pain management. He currently is a managing partner in a multi-physician private pain practice, AABP Integrative Pain Care, located in Brooklyn, NY. He is one of the earliest interventional pain physicians to integrate ultrasound guidance to improve the safety and accuracy of interventional pain procedures.   Awards New York Magazine: Top Doctors: 2016, 2017, 2018, 2021, 2022, 2023, 2024, 2025 Schneps Media: 2015, 2016, 2017, 2019, 2020 Top Doctors New York Metro Area (digital guide): 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023 2025 Schneps Media - Brooklyn Courier Life: 2021, 2022, 2023   Dr. Rosenblum written several book chapters on Peripheral Neuromodulation, Radiofrequency Ablation, and Pharmacology.  He has published numerous noteworthy articles and most recently is developing the ASIPP Guidelines for Peripheral Neuromodulation in the treatment of chronic pain. He has been named several times in NY Magazine's Best Pain Management Doctor List, Nassau County's Best Pain Physician, has appeared on NY1 News, and has made several appearances on XM Radio's Doctor Talk. He currently is lecturing on a national and international level and has partnered with the American Society of Interventional Pain Physicians (ASIPP), American Society of Pain and Neuroscience (ASPN), IASP Mexican Chapter, Eastern Pain Association (EPA), the North American Neuromodulation Society (NANS), World Academy of Pain Medicine United, as well as various other organizations, to support educational events and develop new courses. Since 2008, he has helped over 3000 physicians pass the Pain Management Boards, and has been at the forefront of utilizing ultrasound guidance to perform pain procedures.  He now hosts the PainExam podcast, AnesthesiaExam Podcast, PMRExam Podcasts and uses this platform to promote the safe and effective use of ultrasound in the performance of various procedures such as Peripheral Nerve Stimulation, Caudal Epidurals, Selective Nerve Root Blocks, Cluneal Nerve Blocks, Ganglion impar Blocks, Stellate Ganglion Blocks, Brachial Plexus Blocks, Joint Injections and much more!   Doctor Rosenblum created the NRAP (Neuromodulation Regional Anesthesia and Pain) Academy  and travels to teach various courses focused on Pain Medicine, Regenerative Medicine, Ultrasound Guided Pain Procedures and Regional Anesthesia Techniques.  Dr. Rosenblum is persistent when it comes to eliminating pain and has gained a reputation among his patients for thinking "outside the box" and implements ultrasound guidance to deposit medications, biologics (PRP, Bone Marrow Aspirate, etc.) and Peripheral Nerve Stimulators near pain generators. He is currently treating patients in his great neck and Brooklyn office.  For an appointment go to AABPpain.com or call Brooklyn     718 436 7246 Reference Adriaansen, E. J., Jacobs, J. G., Vernooij, L. M., van Wijck, A. J., Cohen, S. P., Huygen, F. J., & Rijsdijk, M. (2025). 8. Herpes zoster and post herpetic neuralgia. Pain Practice, 25(1), e13423.

Paralyzed from the neck down while playing college football in 1970, Ken Kunken was led to believe the best he could hope for was a career selling magazine subscriptions over the phone. But he battled back from the depths of depression and despair to become an award-winning assistant district attorney. Some men see things as they are and say, "Why?" Ken dreamed of things that never were and said, "Why not?" But the Ken Kunken story is more than overcoming adversity. There's more -- much more.     After a lengthy hospitalization, Ken returned to Cornell, where he completed his undergraduate degree in engineering. Ken earned a Master of Arts degree at Cornell in education, as well as a Master of Education degree at Columbia University in psychology.    Ken became a nationally certified rehabilitation counselor. He worked for more than two years at Abilities, Inc., where he provided vocational and placement counseling to severely disabled individuals.  Was that enough?  Not for Ken! He enrolled in Hofstra University's School of Law and worked for more than 40 years as a Nassau County assistant district attorney, where he became a Deputy Bureau Chief.      It's also a love story that leads Ken to become the biological father of triplets, which was thought to be impossible. Ken's true-life story inspires and motivates others to fight for their dreams against overwhelming odds.   Ken never ever gave up hope. He believed he could lead a useful, productive, and happy life despite his physical disability. Please share his incredible interview:    BUY KEN'S BOOK - CLICK HERE “I Dream of Things That Never Were” describes Ken Kunken's journey from the lowest point in his life after a serious football injury to the pinnacle of happiness and success.

Nassau County DA busts murder-for-hire plot... The father of a missing 2-year-old is brought in for police questioning... Adams announces plans to remove a de-commissioned jail barge from Hunts Point full 359 Mon, 09 Jun 2025 15:39:59 +0000 KrmHwoPjQYT04I5toeVTazXiGowSOFSR #crime,#localnews,#newyork,#nyc,#emailnewsletter,news 1010 WINS ALL LOCAL #crime,#localnews,#newyork,#nyc,#emailnewsletter,news Nassau County DA busts murder-for-hire plot... The father of a missing 2-year-old is brought in for police questioning... Adams announces plans to remove a de-commissioned jail barge from Hunts Point The podcast is hyper-focused on local news, issues and events in the New York City area. This podcast's purpose is to give New Yorkers New York news about their neighborhoods and shine a light on the issues happening in their backyard. 2024 © 2021 Audacy, Inc.

Melissa English faces a grand theft charge in Nassau County, Florida. The former church finance secretary is accused of stealing $570,000 from Amelia Baptist Church between 2019 and 2024. English's arrest was captured by body-worn cameras. Court documents claim she spent the money on purchases from Wal-Mart, Amazon and vacations. Law&Crime's Angenette Levy goes through the body camera footage in this episode of Crime Fix — a daily show covering the biggest stories in crime.PLEASE SUPPORT THE SHOW: If your child, under 21, has been diagnosed with type 2 diabetes or fatty liver disease, visit https://forthepeople.com/food to start a claim now!Host:Angenette Levy https://twitter.com/Angenette5Producer:Jordan ChaconCRIME FIX PRODUCTION:Head of Social Media, YouTube - Bobby SzokeSocial Media Management - Vanessa BeinVideo Editing - Daniel CamachoGuest Booking - Alyssa Fisher & Diane KayeSTAY UP-TO-DATE WITH THE LAW&CRIME NETWORK:Watch Law&Crime Network on YouTubeTV: https://bit.ly/3td2e3yWhere To Watch Law&Crime Network: https://bit.ly/3akxLK5Sign Up For Law&Crime's Daily Newsletter: https://bit.ly/LawandCrimeNewsletterRead Fascinating Articles From Law&Crime Network: https://bit.ly/3td2IqoLAW&CRIME NETWORK SOCIAL MEDIA:Instagram: https://www.instagram.com/lawandcrime/Twitter: https://twitter.com/LawCrimeNetworkFacebook: https://www.facebook.com/lawandcrimeTwitch: https://www.twitch.tv/lawandcrimenetworkTikTok: https://www.tiktok.com/@lawandcrimeSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Bruce Blakeman: Keeping Nassau County Safe for all Learn more about your ad choices. Visit megaphone.fm/adchoices

Bill McIntyre talks with current Nassau County Legislator - and Democratic Candidate for Nassau County Executive - Seth Koslow, about issues affecting the campaign, including the Nassau County Budget, Eisenhower Park, Nassau Coliseum, and his thoughts on the SALT cap in President Trump's "Big Beautiful Bill."

The Americans are coming! Again! Another attempted invasion of British East Florida is thwarted in modern-day Nassau County at a bridge over Alligator Creek (near present-day Callahan). This battle took place in June of 1778.

​In a declaration dated April 17, 2025, Dr. Alexander Sasha Bardey, a forensic psychiatrist, provided expert testimony in the federal case against Sean "Diddy" Combs. Dr. Bardey's extensive credentials include board certifications in psychiatry and forensic psychiatry, and he has been recognized as an expert in various courts across New York and other states. His professional experience encompasses roles such as Director of Forensic Psychiatry for Nassau County and clinical leadership positions in multiple mental health courts and alternative to incarceration programs. In his declaration, Dr. Bardey outlined his qualifications and the scope of his forensic practice, which includes conducting psychiatric evaluations, risk assessments, and providing expert reports for legal proceedings. His involvement in the Combs case suggests that his expertise may be utilized to assess psychological factors pertinent to the defense.Dr. Bardey's declaration serves to establish his authority and the relevance of his forensic psychiatric expertise in the context of the trial. While the specific details of his anticipated testimony are not delineated in the declaration, his background indicates a focus on evaluating mental health aspects that could influence the case's outcome. Such evaluations may pertain to the psychological profiles of individuals involved, assessments of behavior, or considerations of mental state relevant to the charges faced by Combs. The inclusion of Dr. Bardey's declaration underscores the defense's intent to incorporate forensic psychiatric perspectives into their legal strategy.to contact me:bobbycapucci@protonmail.comsource:Sbizhub 45825032114550Become a supporter of this podcast: https://www.spreaker.com/podcast/the-epstein-chronicles--5003294/support.

First-time homebuyers in Nassau County often face delays in mortgage pre-approval due to common mistakes. Avoiding these errors can lead to faster approval, stronger offers, and a smoother homebuying experience. home loan advisor pro City: Bethpage Address: P.O. BOX 1192 Website: https://homeloanadvisorpro.com/

Summer semester is here and the crew changed again. Well, only one person.Another round of Toxic Talk by the Monday Morning Madhouse. Monday Morning Madhouse - May 19, 2025

About our guest: ⁠Dana Arschin⁠ is a 3-time Emmy Award-winning journalist and the first-ever Storyteller for the Holocaust Memorial and Tolerance Center of Nassau County. She spent six years reporting and anchoring at Fox 5 News and previously worked at News 12 The Bronx/Brooklyn, where she earned her first Emmy and multiple New York Press Club awards.  Today, as The Local Reporter, Dana shoots, writes, narrates, and edits broadcast-quality video segments that spotlight local businesses and individuals, using her social media expertise to help expand their reach.Her work is also deeply personal — Dana is the proud granddaughter of a Holocaust survivor. In 2018, she traveled to Poland to explore her family's history, creating the Emmy-winning short film The Forgotten Camps. A Long Island native, Dana is fluent in Spanish, and in her free time enjoys flying trapeze, playing sports, and spending time with her husband and two young daughters. About The PR Podcast: The PR Podcast is a show about how the news gets made. We talk with great PR people, reporters, and communicators about how the news gets made and strategies for publicity that drive business goals. Host ⁠⁠Jody Fisher⁠⁠ is the founder of Jody Fisher PR and works with clients across the healthcare, higher education, financial services, real estate, entertainment, and non-profit verticals.  Dana Arschin: Facebook - https://www.facebook.com/DanaArschinKraslowtwitter - https://x.com/DanaArschinInstagram - https://www.instagram.com/dana_arschin/Linked In - https://www.linkedin.com/in/dana-arschin/website - https://danaarschin.weebly.com The Local Reporter: Instagram - https://www.instagram.com/the.local.reporter/website - https://www.thelocalreporter.info Chow or Never: Instagram - https://www.instagram.com/chow_or_never/ The PR Podcast: Facebook - https://www.facebook.com/ThePRPodcast/ Twitter - https://x.com/ThePRPodcast1 Instagram - https://www.instagram.com/theprpodcast_/ TikTok - https://www.tiktok.com/@theprpodcast? 

Neither did we until now. Here's how it benefits you.

May 15, 2025 - Assemblymember Chuck Lavine, a Long Island Democrat, makes the case for a leadership shakeup at Nassau University Medical Center, the largest public safety net hospital on Long Island.

Bill Horan and Stacy Raine learn about the North Shore Historical Museum - which exists to preserve the history of the North Shore of Long Island through the stewardship of its collections and historic structure to engage the public, and to interpret the history of the North Shore, in particular the area once known as the “Gold Coast”, through exhibitions, lectures, and programs.  They speak with Christopher Judge, the Director of the North Shore Historical Museum, and Gaitley Stevenson-Matthews, one of the museums board members.

Meet Cameron Richards, an honest and hard-working New York State licensed massage therapist and owner of Somatic Massage Therapy. Did you know that the Greek word "Somatic" means relating to the body, especially as distinct from the mind.Cameron shares his origin story in the field, explaining how a job loss led him to pursue massage therapy despite initial reservations, and details his journey from working for others to building his own successful spa. He emphasizes the importance of providing a professional experience to counter negative stereotypes and highlights how building trust through clear communication, a welcoming environment, and skilled therapists is crucial for client satisfaction and business growth. The discussion also touches on marketing strategies, including email and text message campaigns for special offers and memberships, as well as the spa's work with specific client groups like teachers and pregnant women.Book a Massage Therapy Spa Session with Somatic here >>Frequently Asked QuestionsWhat is Somatic Massage Therapy & Spa and how did it start?Somatic Massage Therapy & Spa is a professional massage therapy and spa located in Floral Park, on the border of Queens and Nassau County in New York. The business was founded by Cameron, a New York State licensed massage therapist with 15 years of experience. His journey into massage therapy began unexpectedly after a job loss. Initially hesitant about massage, he was considering acupuncture at a trade school recommended by a friend. An administrator at the school suggested he complete the massage program first, get licensed, and then pursue acupuncture. While the acupuncture plan didn't pan out due to student loans, Cameron discovered a passion for massage and built his business from working out of his home to renting a room in a chiropractor's office, and eventually opening his current ground-floor location with multiple treatment rooms and therapists.What makes Somatic Massage Therapy & Spa different from other spas?Somatic Massage Therapy & Spa focuses on providing a professional and results-oriented experience. They prioritize building trust with clients, especially in an industry that can face negative perceptions. This is achieved through a welcoming and professional environment, well-trained therapists wearing uniforms and name badges, thorough intake processes to understand client needs, and a focus on creating a relaxing ambiance with elements like aromatherapy and soft music. They aim to be more than a "cookie cutter" service, offering personalized treatments and actively working with clients to produce desired results for their pain or stress.How can someone contact Somatic Massage Therapy & Spa or book an appointment?Potential clients within the Floral Park, NY area can contact Somatic Massage Therapy & Spa through their website at somaticmassagepc.com. You can also text the spa at 516-447-4373 or call directly to book an appointment at 516-686-9557. The spa is conveniently located at 113 Jericho Turnpike, Floral Park, NY 11001 and is accessible by bus, the Long Island Railway, and ride-sharing services, with the added benefit of free parking.We can't wait to serve you at Somatic Massage Therapy & Spa!More Resources ⬇️>> ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Join our club community for exclusive information

HEALTHY LIFESTYLE with Host & America's #1 Take Action Success Coach & Strategist Lori Anne Casdia chats with Jan Arkwright about getting organized.  The negative impacts of clutter like increased cortisol levels.  The positive results of decluttering and the steps to getting organized with SPACE (Sort, Purge,Assign it a home, Containerize, Equalize/maintain). Lets Keep the memoriw and lose the stuff.  Clearing out allows you to have space to attract more ...Jan Arkwright is the owner of Before & After Organizing by Jan, a professional organizing company servicing Nassau County, Western Suffolk County, and Queens. Prior to starting her professional organizing career in 1997, Jan was a practicing attorney juggling multiple projects and a lot of paperwork. Jan brings her innate passion for organizing, attention to detail, and project management skills to every client in order to help them achieve their vision of an organized, serene space. The systems she implements with her clients are successful because they are easy to maintain, realistic, and tailored to each client's personality & lifestyle. Jan's services include decluttering, paper flow & time management, kitchen/pantry/closet organization, and space optimization. Jan is a member of the Institute for Challenging Disorganization (ICD) and a Golden Circle Member of the National Association of Productivity and Organizing Professionals (NAPO).To Contact:www.organizingbyjan.comhttps://www.facebook.com/organizingbyjanhttps://www.instagram.com/organizingbyjanhttps://www.linkedin.com/company/before-after-organizing-by-jan-llcSee Coach Lori Anne on her TV show "Help Me Understand with Coach Lori Anne" - Roku, Amazon Fire, YouTube, Facebook, Linked In, X/Twitter.  Find us on BOLD BRAVE TV  every Thursday night at 7PM EST. Like and Follow to get announcements and alerts. A FREE Gift from Lori Anne: 3 Steps to Cleaning up you Opens, Messes & IncompletesTAKE the  FREE Super Ball Quiz  - What's your bounce pattern?  This is a quick 5 minute quiz to provide you with information where you are and what you can focus on to step into the next version of you.  Bonus is FREE 30 minute session with Coach Lori Anne as she takes you through your Bounce Pattern results. Let's talk! Book your appointment herePlease email us at HealthyLifestylewithLA@gmail.com Follow us on social media @healthylifestylewithLA @Coach Lori AnneHere is your access to Coach Lori Anne's Workshops (where we are training while you are implementing):Step into Living Your Best Life  and for more infomation please go to LDC STRATEGIES and you can visit our TAKE ACTION ACADEMY - for programs, coaching, coach on call, workshops and more.  Action Accelerator Workshop Series You can attend one (they work stand alone) or every workshop as each workshop stacks (works) with the next workshop.January: New Year Vision & Goal Setting WorkshopFebruary: Activation Vision Board WorkshopMarch: Spring Into Activation WorkshopApril: Spring Clean Your Business WorkshopMay: Productivity & Habit Tracker WorkshopJune: Slaying Imposter Syndrome Workshop July: High Vibes Spiritual Healing WorkshopAugust: Self-Care Everyday Workshop September: Forged in Fire Pre Retreat WorkshopOctober: Uncover Your Unique Transformation Workshop November:Dream Big Workshop December: 12 Days to TransformationOur Goal at Healthy Lifestyle is to empower minds, educate hearts, inspire action and ignite success so  you can choose to have a fulfilled Healthy, Emotional, Spiritual, and Physical life, to live the life you have always wanted and dreamedAbout Our HostShe's not just your average success guru; oh no, she's the guiding light on your journey to becoming the most vibrant, authentic version of yourself!Coach Lori Anne is America's #1 Take Action Success Coach & Strategist teaching founders and entrepreneurs how to put a sustainable business model under their dream and actualize their vision of success. Coach Lori Anne is a decision partner, delivering strategic distinctions, tailored tactics and key connections."As your coach, I make suggestions, You make decisions" ~ Coach Lori AnneCoach Lori Anne isn't just about boosting profits; she's on a mission to nurture your spirit, fuel your passions, and ignite the flames of growth within your soul. With a heart as expansive as the universe itself, she's dedicated to fostering a culture of love, kindness, and personal empowerment.Imagine a world where every setback is a stepping stone, every challenge a chance for growth, and every dream a seed waiting to bloom. That's the world Coach Lori Anne invites you to inhabit, where self-discovery is celebrated, and every moment is an opportunity to shine becoming the Next Best Version of Yourself.As a result of her work, Coach Lori Anne's clients grow their business anywhere of 75 to 200% over the course of 12-18 months.Through her gentle guidance and unwavering support, Coach Lori Anne helps you peel back the layers of self-doubt, revealing the radiant gem that lies within.

Mark discusses MSNBC's latest ratings troubles; Trump's lawsuit against 60 Minutes; a possible Steven Colbert lawsuit; Bill Belicheck and his girlfriend; Ed Martin and NewsMax interview interrupted; update with the cause of the helicopter crash weeks ago; Mark Zuckerberg buying Instagram and its value now; Nassau County candidate Bruce Blakeman endorsed by President Trump; Kentucky Derby winner news; NPR and PBS loss of funding.

Mark discusses MSNBC's latest ratings troubles; Trump's lawsuit against 60 Minutes; a possible Steven Colbert lawsuit; Bill Belicheck and his girlfriend; Ed Martin and NewsMax interview interrupted; update with the cause of the helicopter crash weeks ago; Mark Zuckerberg buying Instagram and its value now; Nassau County candidate Bruce Blakeman endorsed by President Trump; Kentucky Derby winner news; NPR and PBS loss of funding.See omnystudio.com/listener for privacy information.

This is your morning All Local update for Monday, May 5, 2025.

More buyers in Nassau County are getting pre-qualified before house hunting. It's a smart first step that helps buyers understand their budget, stand out to sellers, and move quickly in today's competitive market. home loan advisor pro City: Bethpage Address: P.O. BOX 1192 Website: https://homeloanadvisorpro.com/

Non-Profit 4-26-25 P7 Stanford Perry - AHRC of Nassau County by JVC Broadcasting

Note: We are back from parental leave! This episode was originally released August 22nd, 2024. We are re-airing it today in light of New York Governor Kathy Hochul's ongoing push to force a mask ban through New York state budget negotiations, as Artie explains in a brief intro at the top of the episode. Please note that the county-level mask ban discussed in this episode was implemented last year; as we discussed in our episode Covid Year Five, within a week of implementation the law was used to arrest an individual for masking in circumstances that sound like a revival of New York's racist stop and frisk initiative. Original description: Beatrice, Artie and Jules discuss the mask ban passed in Nassau County last week, the latest in a dramatic rise in legislation criminalizing face masks and targeting the Palestine solidarity movement. We look at what happened in the overtly hostile public hearing over the ban, the history of the New York statute that ban proponents want back, and how the threat of mask bans goes far beyond public health: mask bans embolden racist policing; they're anti-trans; and they target the whole of the left. Transcript: https://www.deathpanel.net/transcripts/mask-bans-are-everyones-fight Watch the full Nassau County mask ban hearing here: vimeo.com/994184432 Find our book Health Communism here: www.versobooks.com/books/4081-health-communism Find Jules' latest book, A Short History of Trans Misogyny, here: https://www.versobooks.com/products/3054-a-short-history-of-trans-misogyny Death Panel merch here (patrons get a discount code): www.deathpanel.net/merch As always, support Death Panel at www.patreon.com/deathpanelpod

Bruce Blakeman, Nassau County Executive, joins the show to discuss President Trump vowing to fight for a Long Island town to keep its school's team name and logo after New York State demanded their removal because of a ban on Native American imagery. The Massapequa school board called on Trump after losing a tooth-and-nail battle in court for nearly two years to keep “Chiefs,” a nod to the area's Native American ancestors, as the school's logo. Blakeman then dives into the other news of the day pertaining to Nassau County on Long Island. Learn more about your ad choices. Visit megaphone.fm/adchoices

On this Thursday edition of Sid & Friends in the Morning, Sid previews tonight's opening round of the 2025 NFL Draft, coming to you live from Green Bay, Wisconsin. In other news of the day, disgraced former Governor and now Mayoral candidate Andrew Cuomo gets interrupted by livid protesters at a NYC Mayoral Forum last night, Cornell University cancels the appearance of a performer who is staunchly anti-Israel and anti-Semitic, Congresswoman and hopefully future Gubernatorial candidate in Elise Stefanik goes after Albany's deliberate destruction of NYC, the Las Vegas Sands opts out of funding a casino in Nassau County, and President Trump signs an executive order overhauling higher education in America. Jennifer Harrison, Bruce Blakeman, Craig Carton, Bill O'Reilly and Justine Brooke Murray join Sid on this Friday-eve installment of Sid & Friends in the Morning. Learn more about your ad choices. Visit megaphone.fm/adchoices

​In a declaration dated April 17, 2025, Dr. Alexander Sasha Bardey, a forensic psychiatrist, provided expert testimony in the federal case against Sean "Diddy" Combs. Dr. Bardey's extensive credentials include board certifications in psychiatry and forensic psychiatry, and he has been recognized as an expert in various courts across New York and other states. His professional experience encompasses roles such as Director of Forensic Psychiatry for Nassau County and clinical leadership positions in multiple mental health courts and alternative to incarceration programs. In his declaration, Dr. Bardey outlined his qualifications and the scope of his forensic practice, which includes conducting psychiatric evaluations, risk assessments, and providing expert reports for legal proceedings. His involvement in the Combs case suggests that his expertise may be utilized to assess psychological factors pertinent to the defense.Dr. Bardey's declaration serves to establish his authority and the relevance of his forensic psychiatric expertise in the context of the trial. While the specific details of his anticipated testimony are not delineated in the declaration, his background indicates a focus on evaluating mental health aspects that could influence the case's outcome. Such evaluations may pertain to the psychological profiles of individuals involved, assessments of behavior, or considerations of mental state relevant to the charges faced by Combs. The inclusion of Dr. Bardey's declaration underscores the defense's intent to incorporate forensic psychiatric perspectives into their legal strategy.to contact me:bobbycapucci@protonmail.comsource:Sbizhub 45825032114550

​In a declaration dated April 17, 2025, Dr. Alexander Sasha Bardey, a forensic psychiatrist, provided expert testimony in the federal case against Sean "Diddy" Combs. Dr. Bardey's extensive credentials include board certifications in psychiatry and forensic psychiatry, and he has been recognized as an expert in various courts across New York and other states. His professional experience encompasses roles such as Director of Forensic Psychiatry for Nassau County and clinical leadership positions in multiple mental health courts and alternative to incarceration programs. In his declaration, Dr. Bardey outlined his qualifications and the scope of his forensic practice, which includes conducting psychiatric evaluations, risk assessments, and providing expert reports for legal proceedings. His involvement in the Combs case suggests that his expertise may be utilized to assess psychological factors pertinent to the defense.Dr. Bardey's declaration serves to establish his authority and the relevance of his forensic psychiatric expertise in the context of the trial. While the specific details of his anticipated testimony are not delineated in the declaration, his background indicates a focus on evaluating mental health aspects that could influence the case's outcome. Such evaluations may pertain to the psychological profiles of individuals involved, assessments of behavior, or considerations of mental state relevant to the charges faced by Combs. The inclusion of Dr. Bardey's declaration underscores the defense's intent to incorporate forensic psychiatric perspectives into their legal strategy.to contact me:bobbycapucci@protonmail.comsource:Sbizhub 45825032114550Become a supporter of this podcast: https://www.spreaker.com/podcast/the-moscow-murders-and-more--5852883/support.

Mazi Pilip, Israeli-American politician serving in New York's Nassau County Legislature, joins Sid live in-studio to gift Sid a very special belated birthday present, President Trump-theme shmurah matzah, of which Mazi sent boxes of directly to the President and his family at Mar-a-Lago and The White House. Mazi then covers all the news of the day pertaining to the Jewish homeland of Israel.  Learn more about your ad choices. Visit megaphone.fm/adchoices

​In a declaration dated April 17, 2025, Dr. Alexander Sasha Bardey, a forensic psychiatrist, provided expert testimony in the federal case against Sean "Diddy" Combs. Dr. Bardey's extensive credentials include board certifications in psychiatry and forensic psychiatry, and he has been recognized as an expert in various courts across New York and other states. His professional experience encompasses roles such as Director of Forensic Psychiatry for Nassau County and clinical leadership positions in multiple mental health courts and alternative to incarceration programs. In his declaration, Dr. Bardey outlined his qualifications and the scope of his forensic practice, which includes conducting psychiatric evaluations, risk assessments, and providing expert reports for legal proceedings. His involvement in the Combs case suggests that his expertise may be utilized to assess psychological factors pertinent to the defense.Dr. Bardey's declaration serves to establish his authority and the relevance of his forensic psychiatric expertise in the context of the trial. While the specific details of his anticipated testimony are not delineated in the declaration, his background indicates a focus on evaluating mental health aspects that could influence the case's outcome. Such evaluations may pertain to the psychological profiles of individuals involved, assessments of behavior, or considerations of mental state relevant to the charges faced by Combs. The inclusion of Dr. Bardey's declaration underscores the defense's intent to incorporate forensic psychiatric perspectives into their legal strategy.to contact me:bobbycapucci@protonmail.comsource:Sbizhub 45825032114550Become a supporter of this podcast: https://www.spreaker.com/podcast/the-epstein-chronicles--5003294/support.

Opening statements set for today in the retrial of former movie mogul Harvey Weinstein... 3,000 people evacuated because of a wildfire in South Jersey... Nassau County police are expected to release the ID of another Gilgo Beach victim full 593 Wed, 23 Apr 2025 09:53:50 +0000 9WtXdWJTShJvjLGcHVtP5zx1QXtv8zrC news 1010 WINS ALL LOCAL news Opening statements set for today in the retrial of former movie mogul Harvey Weinstein... 3,000 people evacuated because of a wildfire in South Jersey... Nassau County police are expected to release the ID of another Gilgo Beach victim The podcast is hyper-focused on local news, issues and events in the New York City area. This podcast's purpose is to give New Yorkers New York news about their neighborhoods and shine a light on the issues happening in their backyard. 2024 © 2021 Audacy, Inc.

This is your afternoon All Local update on April 23, 2025.

Jan in Nassau County called Mark to let him know something she saw online the other day he should know. Vincent in Brooklyn NY calls Mark to tell him that Senator Adam Schiff allegedly got caught with Mortgage fraud himself like Letitia James is accused of. See omnystudio.com/listener for privacy information.

Jan in Nassau County called Mark to let him know something she saw online the other day he should know. Vincent in Brooklyn NY calls Mark to tell him that Senator Adam Schiff allegedly got caught with Mortgage fraud himself like Letitia James is accused of.

Mike Hahaj, Director of Commercial Development & Operations at Raydient Places + Properties, describes how placemaking, conservation, and sustainable funding are shaping the future of Wildlight, a 24,000-acre community in Nassau County, Florida. For show notes and more: https://ninedotarts.com/podcast-funding-the-future 

Summary of the Case and Victims:The discovery of Shannan Gilbert: The case came to light in May 2010 when 24-year-old Shannan Gilbert, an escort, disappeared in the Oak Beach area of Long Island. Her disappearance sparked an extensive search, and during that process, police discovered the remains of other bodies in the vicinity.The initial findings: In December 2010, the remains of four women were found along the remote stretch of Ocean Parkway near Gilgo Beach. All of them were wrapped in burlap sacks. These victims were later identified as:a. Maureen Brainard-Barnes (25): She had gone missing in July 2007. b. Melissa Barthelemy (24): She disappeared in July 2009. c. Amber Lynn Costello (27): She went missing in September 2010. d. Megan Waterman (22): She disappeared in June 2010.Additional victims: In April 2011, the remains of six more people were discovered along Ocean Parkway, including:a. Jessica Taylor (20): She had been missing since July 2003. b. Jane Doe #6: Unidentified victim. c. Jane Doe #7: Unidentified victim. d. Jane Doe #8: Unidentified victim.Disappearance of an escort: In March 2012, 22-year-old escort, Shannan Gilbert's remains were finally found in a marshy area near Oak Beach. Her death was ruled as an accidental drowning, but some believe she might have been connected to the killer.Other potential victims: The investigation also probed the possibility of additional victims connected to the Long Island Serial Killer. Among them was an unidentified Asian male found in Nassau County in 2000, and a dismembered female found in 1996 in Manorville, New York, which was also attributed to a potential serial killer.Now, after the arrest of Rex Heuermann other cold cases are being looked at to see if he has any connection. One of those cases is Carmen Vargas. In this episode we hear form Carmen's niece who tells her aunts story and why she thinks that her death is connected to Rex Heuermann.(commercial at 11:31)to contact me:bobbycapucci@protonmail.comsource:Gilgo Beach victims & 'LISK's potential first kill Carmen Vargas' remains share disturbing similarities,' niece reveals | The US Sun (the-sun.com)

Summary of the Case and Victims:The discovery of Shannan Gilbert: The case came to light in May 2010 when 24-year-old Shannan Gilbert, an escort, disappeared in the Oak Beach area of Long Island. Her disappearance sparked an extensive search, and during that process, police discovered the remains of other bodies in the vicinity.The initial findings: In December 2010, the remains of four women were found along the remote stretch of Ocean Parkway near Gilgo Beach. All of them were wrapped in burlap sacks. These victims were later identified as:a. Maureen Brainard-Barnes (25): She had gone missing in July 2007. b. Melissa Barthelemy (24): She disappeared in July 2009. c. Amber Lynn Costello (27): She went missing in September 2010. d. Megan Waterman (22): She disappeared in June 2010.Additional victims: In April 2011, the remains of six more people were discovered along Ocean Parkway, including:a. Jessica Taylor (20): She had been missing since July 2003. b. Jane Doe #6: Unidentified victim. c. Jane Doe #7: Unidentified victim. d. Jane Doe #8: Unidentified victim.Disappearance of an escort: In March 2012, 22-year-old escort, Shannan Gilbert's remains were finally found in a marshy area near Oak Beach. Her death was ruled as an accidental drowning, but some believe she might have been connected to the killer.Other potential victims: The investigation also probed the possibility of additional victims connected to the Long Island Serial Killer. Among them was an unidentified Asian male found in Nassau County in 2000, and a dismembered female found in 1996 in Manorville, New York, which was also attributed to a potential serial killer.After years of inaction and ineptitude shown by the Suffolk County Police department, a new regime came into town and did something that we rarely see from politicians: They kept their word. In this episode, we hear from Commissioner Harrison who sat down with Newsday to talk about the arrest of Rex Heuermann and where things currently stand.(commercial at 9:37)to contact me:bobbycapucci@protonmail.comsource:Rex Heuermann engaged in ‘disturbing' behavior up to arrest (nypost.com)

Former Mayor Bill de Blasio isn't ready to back any candidates in New York City's mayoral race. Plus, some Muslim worshippers on Long Island have a new ally in a quest to build an upgraded mosque in Nassau County. Also, there are a couple days left of juror selection in the high profile case of Harvey Weinstein. And finally, the Forest Hills Stadium summer concert series is officially back on after months of bitter standoff between venue organizers and a group of residents in the area.

New York officials say their climate change will continue despite an executive order from President Trump. The fight between Avelo Airlines and the state of Connecticut continues. Nassau County sees a spike in rabies cases in animals over the past year and a half. Plus, a conversation with one of America's most well-known Jesuit priests.

Job cuts at an energy assistance program could impact 200,000 Connecticut residents. A new poll shows the cost of food and housing are top concerns for Long Islanders. An MS-13 leader was arrested in Nassau County this week. Plus, will Governor Lamont's plan for universal pre-K prevail?

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Red Apple Podcast Host Bo Dietl hops back on the program to discuss his support for Team Sagi, an initiative by the Council of Jewish Organizations of Nassau County, headed by Sagi Dovev who was a guest on this very morning show just three days ago. Bo then dives into the rest of the top local headlines in the news today.  Learn more about your ad choices. Visit megaphone.fm/adchoices

CONNECT WITH JULIE MATTSON:• Website: https://pushinguplilies.com• Facebook: https://www.facebook.com/pushinguplilies

Mazi Pilip, Israeli-American politician serving in New York's Nassau County Legislature, joins Sid live in-studio to discuss the ceasefire agreement in the Middle East between Israel and Hamas, which ended over the weekend. Learn more about your ad choices. Visit megaphone.fm/adchoices

On November 20th, 1993, the sexually violated and mutilated corpse of a young woman is found on Long Island, New York. The first of over ten bodies found in the coming decades of young, petite, sex workers, whose murders will later be attributed to "The Long Island Serial Killer." But no suspect will be arrested until July of 2023. Why did it take law enforcement three decades to find this guy, how did they find him, and who is he? All this and more on this week's true crime deep dive. Merch and more: www.badmagicproductions.com Timesuck Discord! https://discord.gg/tqzH89vWant to join the Cult of the Curious PrivateFacebook Group? Go directly to Facebook and search for "Cult of the Curious" to locate whatever happens to be our most current page :)For all merch-related questions/problems: store@badmagicproductions.com (copy and paste)Please rate and subscribe on Apple Podcasts and elsewhere and follow the suck on social media!! @timesuckpodcast on IG and http://www.facebook.com/timesuckpodcastWanna become a Space Lizard? Click here: https://www.patreon.com/timesuckpodcast.Sign up through Patreon, and for $5 a month, you get access to the entire Secret Suck catalog (295 episodes) PLUS the entire catalog of Timesuck, AD FREE. You'll also get 20% off of all regular Timesuck merch PLUS access to exclusive Space Lizard merch.

Bahar Ostadan, Nassau County politics reporter at Newsday Media Group, reports on the news that Nassau County has authorized its police detectives to work with the U.S. Immigration and Customs Enforcement to arrest and deport undocumented immigrants accused of committing crimes.